Chemosensory receptor ligand-based therapies

ABSTRACT

Provided herein are methods for treating diabetes, obesity, and other metabolic diseases, disorders or conditions comprising chemosensory receptor ligands. Also provided herein are chemosensory receptor ligand compositions and the preparation thereof for the methods of the present invention.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a divisional application of U.S. application Ser.No. 12/907,909, filed Oct. 19, 2010 (now U.S. Pat. No. 8,828,953) whichclaims the benefit of U.S. application Ser. No. 12/763,926, filed Apr.20, 2010 and is related to U.S. Provisional Application No. 61/170,657,filed Apr. 20, 2009, all of which are incorporated herein by reference.

BACKGROUND OF THE INVENTION

Despite the longstanding, massive, effort to develop effectivetreatments for diabetes, metabolic syndrome, obesity, and relatedmetabolic conditions, the number of people worldwide who suffer fromthem is rapidly growing. These conditions result in numerous medicalcomplications, a lowered quality of life, shortened lifespan, lost workproductivity, a strain on medical systems, and a burden on medicalinsurance providers that translates into increased costs for all.

Type II diabetes treatments in use or development are designed to lowerblood glucose levels. They include mimetics of GLP-1 (glucagon-likepeptide-1), a hormone that plays a key role in regulating insulin,glucose and hunger. Examples of mimetics are the GLP-1 receptor agonist,Exenatide (Byetta) and the GLP-1 analog Liraglutide. Other drugs inhibitDPP-IV, an enzyme that rapidly degrades endogenous GLP-1. Exenatide is aGLP-1 receptor agonist that is degraded more slowly by DPP-IV.Liraglutide, a GLP-1 analog, is attached to a fatty acid molecule thatbinds to albumin and slows the rate of GLP-1 release and itsdegradation. (See, e.g., Nicolucci, et al., 2008, “Incretin-basedtherapies: a new potential treatment approach to overcome clinicalinertia in type 2 diabetes,” Acta Biomedica 79(3):184-91 and U.S. Pat.No. 5,424,286 “Exendin-3 and exendin-4 polypeptides, and pharmaceuticalcompositions comprising same.”)

Until very recently obesity treatments include two FDA-approved drugs.Orlistat (Xenical) reduces intestinal fat absorption by inhibitingpancreatic lipase. Sibutramine (Meridia), taken off the market in Europeand the USA, decreases appetite by inhibiting deactivation of theneurotransmitters norepinephrine, serotonin, and dopamine. Undesirableside-effects, including effects on cholesterol levels, have beenreported with these drugs. Undesirable side-effects, including effectson cholesterol levels, have been reported with these drugs. (See, e.g.,“Prescription Medications for the Treatment of Obesity,” NIH PublicationNo. 07-4191, December 2007). Surgical treatments including gastricbypass surgery and gastric banding are available, but only in extremecases. These procedures can be dangerous, and furthermore are notappropriate options for patients with more modest weight loss goals.

Certain intestinal cells, L cells, have been reported to produce GLP-1in response to glucose, fat and amino acid stimulation. These and othersuch “enteroendocrine cells” also produce other hormones involved inprocesses relating to glucose and fuel metabolism, includingoxyntomodulin, reported to ameliorate glucose intolerance and suppressappetite, PYY (peptide YY), also observed to suppress appetite, CCK(cholecystokinin), which reportedly stimulates the digestion of fat andprotein and also reduces food intake, GLP-2, which reportedly inducesgut cell proliferation, and GIP (gastric inhibitory polypeptide, alsocalled glucose-dependent insulinotropic peptide), an incretin secretedfrom the intestinal K cells that has been observed to augmentglucose-dependent insulin secretion. (See, e.g., Jang, et al., 2007,“Gut-expressed gustducin and taste receptors regulate secretion ofglucagon-like peptide-1,” PNAS 104(38):15069-74 and Parlevliet, et al.,2007, “Oxyntomodulin ameliorates glucose intolerance in mice fed ahigh-fat diet,” Am J Physiol Endocrinol Metab 294(1):E142-7).

It has also been reported that there are taste receptor-like elementspresent on the L-cells and K-cells in the intestine (Hofer, et al.,1996, “Taste receptor-like cells in the rat gut identified by expressionof alpha-gustducin” Proc Natl Acad Sci USA 93:6631-6634). For example,the sweet taste receptors are heterodimers of the T1R2 and T1R3 GPCRsand have been proposed to be identical to those sweet taste receptorsfound on taste buds. The umami receptors are reported to be T1R1 andT1R3 heterodimers (Xu, et al., 2004, “Different functional roles of T1Rsubunits in the heteromeric taste receptors,” Proc Natl Acad Sci USA101: 14258-14263 and Sternini, et al., 2008, “Enteroendocrine cells: asite of ‘taste’ in gastrointestinal chemosensing,” Curr Opin EndocrinolDiabetes Obes 15: 73-78). Stimulation of taste or taste-like receptorsby luminal nutrients has resulted in apical secretion of L-cell productssuch as GLP-1, PYY, oxyntomodulin and glycentin, and K-cell productssuch as GIP, and into the portal vein (Jang, et al., 2007, PNAS104(38):15069-74). In a glucose-dependent manner, GLP-1 and GIP increaseinsulin release from beta cells (an effect known as the incretineffect). In addition, GLP-1 inhibits glucagon release and gastricemptying. GLP-1, oxyntomodulin and PYY 3-36 are considered to be satietysignals (Strader, et al., 2005, “Gastrointestinal hormones and foodintake,” Gastroenterology 128: 175-191). Receptors for fatty acids(e.g., GPR40 and/or GPR120) (Hirasawa, et al., 2005, Free fatty acidsregulate gut incretin glucagon-like peptide-1 secretion through GPR120,Nat Med 11: 90-94) and bile acids (e.g., Gpbar1/M-Bar/TGR5) (Maruyama,et al., 2006, “Targeted disruption of G protein-coupled bile acidreceptor 1 (Gpbar1/M-Bar) in mice.” J Endocrinol 191: 197-205 andKawamata, et al., 2003, “A G protein-coupled receptor responsive to bileacids,” J Biol Chem 278: 9435-9440) are also present in enteroendocrinecell lines. There are also a large number of over 50 T2Rs along with alarge number of haplotypes which comprise bitter receptors. The putativesour and salty receptors, which likely include ion channels, have notbeen completely characterized in humans. See, e.g., Chandrashekar etal., 2010, “The cells and peripheral representation of sodium taste inmice,” Nature 464(7286): 297-301. Although it has been proposed thatablation of certain taste cells resulted in loss of behavior response toonly sour stimuli, no specific taste behavior tests were performed.Thus, the status of identification of a sour receptor is unclear. See,e.g., Shin et al., “Ghrelin is produced in taste cells and ghrelinreceptor null mice show reduced taste responsivity to salty (NaCl) andsour (citric acid) taste,” 2010, PLoSONE 5(9): e12729. GP120, a GPCRcorresponding to an fatty acid receptor, has also been identified in thetaste buds of mice and, furthermore, ω3 fatty acids have been shown tomediate anti-inflammatory effects and reverse insulin resistance inobese mice via their actions on GP120 present in macrophages. See, e.g.,Oh et al., “GPR120 Is an Omega-3 Fatty Acid Receptor Mediating PotentAnti-inflammatory and Insulin-Sensitizing Effects,” 2010, Cell 142(5):687-698; Satiel, “Fishing Out a Sensor for Anti-inflammatory Oils,”2010, Cell 142(5): 672-674; also see Matsumura et al., “Colocalizationof GPR120 with phospholipase Cbeta2 and alpha-gustducin in the taste budcells in mice,” 2009, Neurosci Lett 450: 186-190.

SUMMARY OF THE INVENTION

Provided herein are compositions having at least one chemosensoryreceptor ligand and methods of treatment using the compositions.Diseases and conditions to be treated with the compositions describedherein include metabolic syndrome, insulin resistance, diabetes type I,diabetes type II, diabetes-associated conditions, obesity, glucoseintolerance, gestational diabetes mellitus (GDM), dyslipidemia,post-prandial dyslipidemia, inflammatory bowel disease (IBD), includingulcerative colitis and Crohn's disease, irritable bowel syndrome (MS),short bowel syndrome, polycystic ovary syndrome (PCOS), non-alcoholicfatty liver disease (NAFL), non-alcoholic steatohepatitis (NASH),anorexia, food addiction, food craving, binge eating, weight loss,depression, and mood disorders. Also provided herein are compositions ofat least one chemosensory receptor ligand and an optional metabolite.

The compositions described herein can be delivered to the upper or smallintestine, to the lower or large intestine, or both. Administration ofthe compositions into the intestine is via any known method includingoral.

In one aspect, the compositions described herein are adapted to releasea therapeutically effective amount of a chemosensory ligand to one ormore regions of the intestine. In some embodiments, the compositionsdescribed herein further release at least some of the chemosensoryreceptor ligand in the stomach. In some embodiments, the compositionsare adapted to release in the duodenum, jejunum, ileum, caecum, colonand/or rectum. In other embodiments, the compositions are adapted torelease in the jejunum, ileum, caecum, colon and/or rectum. In someembodiments, the composition is formulated for release in the lowerintestine. In further embodiments, the composition is formulated forrelease in the upper intestine. In still further embodiments, thecomposition is formulated for release in the upper intestine and lowerintestine.

Also provided herein are compositions having at least one chemosensoryreceptor ligand wherein the composition has a sweetness potency of atleast about 100 times the sweetness potency of sucrose, and wherein thecomposition is adapted to release the ligand to one or more regions ofthe intestine of a subject. In one embodiment, the composition has asweetness potency of at least about 500 times the sweetness potency ofsucrose. In one embodiment, the composition has a sweetness potency ofat least about 1000 times the sweetness potency of sucrose.

Also provided herein are compositions having at least one chemosensoryreceptor ligand wherein the composition has a sweetness potencyequivalent to at least about 500 grams of sucrose, and wherein thecomposition is adapted to release the ligand to one or more regions ofthe intestine of a subject. In one embodiment, the composition has asweetness potency equivalent to at least about 5000 grams of sucrose. Inone embodiment, the composition has a sweetness potency equivalent to atleast about 10000 grams of sucrose.

In one embodiment, a composition releases a chemosensory receptor ligandat an onset of about 5 to about 45 minutes, about 105 to about 135minutes, about 165 to about 195 minutes or about 225 to about 255minutes, or a combination of times thereof following oral administrationto a subject.

In other embodiments, a composition releases a chemosensory receptorligand at an onset of about pH 5.0, about pH 5.5, about pH 6.0, about pH6.5, about pH 7.0, or combination thereof following oral administrationto a subject.

In certain embodiments, one or more chemosensory receptor ligands isselected from a sweet receptor ligand, a bitter receptor ligand, anumami receptor ligand, a fat receptor ligand, a bile acid receptorligand, or any combination thereof. Sweet receptor ligands includeglucose, sucralose, aspartame, Stevioside, Rebaudioside, Neotame,acesulfame-K, and saccharin. Bitter receptor ligands include flavanones,flavones, flavonols, flavans, phenolic flavonoids, isoflavones, limonoidaglycones, glucosinolates or hydrolysis product thereof, and organicisothiocyanates. Umami receptor ligands include glutamate salts,glutamines, acetyl glycines, or aspartame. Fat receptor ligands includelinoleic acids, oleic acids, palmitates, oleoylethanolamides, mixedfatty acid emulsion, omega-3 fatty acids andN-acylphosphatidylethanolamine (NAPE). Bile acids include deoxycholicacids, taurocholic acids and chenodeoxycholic acids. In certainembodiments, the chemosensory receptor ligand is nonmetabolized. Incertain embodiments, the chemosensory receptor ligand is an agonist. Incertain embodiments, the chemosensory receptor ligand is an enhancer.

The compositions described herein can be formulated with an entericcoating. In some embodiments, the composition has an enteric coating. Inanother aspect, the compositions described herein can be formulated witha modified release system. In yet another aspect, the compositionsdescribed herein can be formulated with a timed release system. In afurther aspect, the compositions described herein can be formulated witha modified release and enteric coating. In yet a further aspect, thecompositions described herein can be formulated with a timed release andenteric coating.

Provided herein is a method of treating a condition associated with achemosensory receptor in a subject comprising administering acomposition described herein to the subject. In one aspect, thecomposition comprises at least one chemosensory receptor ligand to thesubject. In another aspect, the composition is adapted to release atherapeutically effective amount of a chemosensory ligand to one or moreregions of the intestine.

Provided herein is a method of treating a condition associated with achemosensory receptor in a subject by administering a compositioncomprising at least two chemosensory receptor ligands to the subject.

Provided herein is a method of treating a condition associated with achemosensory receptor in a subject by administering a compositioncomprising at least one chemosensory receptor ligand and a cognatemetabolite. In some embodiments, the metabolite is administered afterthe administration of the chemosensory receptor ligand. In anotherembodiment, the metabolite is co-administered with the chemosensoryreceptor ligand. In further embodiments, the chemosensory receptorligand is co-administered with the ingestion of food by the subject orthe chemosensory ligand is administered before the subject ingests food.In certain instances, food itself may comprise one or more chemosensoryreceptor ligands. In certain instances, food itself may serve as ametabolite.

Provided herein is a method of treating a condition associated with achemosensory receptor by administering a composition having at least onechemosensory receptor ligand to the lower intestine of a subject. Inanother embodiment, the composition comprising at least one chemosensoryreceptor ligand is administered to the upper intestine of a subject. Inyet another embodiment, the composition comprising at least onechemosensory receptor ligand is administered to the upper intestine andlower intestine of a subject. In certain instances, chemosensoryreceptor ligand in the upper intestine and lower intestine is the samechemosensory receptor ligand. In certain instances, chemosensoryreceptor ligand in the upper intestine and lower intestine is differentchemosensory receptor ligands.

Provided herein is a method of treating a condition associated with achemosensory receptor by administering a composition having at least onechemosensory receptor ligand to the duodenum, jejunum, ileum, caecum,colon and/or rectum. In other embodiments, the composition comprising atleast one chemosensory receptor ligand is administered to the duodenumof a subject. In another embodiment, the composition comprising at leastone chemosensory receptor ligand is administered to the jejunum of asubject. In another embodiment, the composition comprising at least onechemosensory receptor ligand is administered to the ileum of a subject.In another embodiment, the composition comprising at least onechemosensory receptor ligand is administered to the caecum of a subject.In another embodiment, the composition comprising at least onechemosensory receptor ligand is administered to the colon of a subject.In another embodiment, the composition comprising at least onechemosensory receptor ligand is administered to the rectum of a subject.In another embodiment, the composition comprising at least onechemosensory receptor ligand is administered to the duodenum, jejunum,ileum, caecum, colon and/or rectum of a subject. In yet anotherembodiment, the composition releases at least some of the chemosensoryreceptor ligand into the stomach.

Provided herein is a method of treating a condition associated with achemosensory receptor by administering one or more chemosensory receptorligand compositions that release at an onset about 5 to about 45minutes, about 105 to about 135 minutes, about 165 to about 195 minutes,about 225 to about 255 minutes or a combination of times thereoffollowing oral administration to a subject.

Provided herein is a method of treating a condition associated with achemosensory receptor by administering one or more chemosensory receptorligand compositions that have an onset of release at about 10 minutes,about 30 minutes, about 120 minutes, about 180 minutes, about 240minutes or a combination of times thereof following oral administrationto a subject. In one embodiment, the composition releases at an onset ofabout 10 minutes following administration to a subject. In oneembodiment, the composition releases at an onset of about 30 minutesfollowing administration to a subject. In one embodiment, thecomposition releases at an onset of about 120 minutes followingadministration to a subject. In one embodiment, the composition releasesat an onset of about 180 minutes following administration to a subject.In one embodiment, the composition releases at an onset of about 240minutes following administration to a subject. In one embodiment, thecomposition releases at an onset of about 10 minutes, 30 minutes, about120 minutes, about 180 minutes and about 240 minutes following oraladministration to a subject.

Provided herein is a method of treating a condition associated with achemosensory receptor by administering a one or more chemosensoryreceptor ligand compositions that has an onset of release at about pH5.5, about pH 6.0, about pH 6.5, and/or about pH 7.0.

Provided herein is a method of treating a condition associated with achemosensory receptor by administering one or more compositions havingat least one chemosensory receptor ligand wherein the compositionsrelease at an onset of two different pH ranges, wherein said two pHranges are selected from about pH 5.0 to about pH 6.0, about pH 6.0 toabout pH 7.0 and about pH 7.0 to about pH 8.0.

In certain embodiments of the methods described herein, one or morechemosensory receptor ligand is selected from a sweet receptor ligand, abitter receptor ligand, an umami receptor ligand, a fat receptor ligand,a bile acid receptor ligand, or any combination thereof. Sweet receptorligands include glucose, sucralose, aspartame, Stevioside, Rebaudioside,Neotame, acesulfame-K, and saccharin. Bitter receptor ligands includeflavanones, flavones, flavonols, flavans, phenolic flavonoids,isoflavones, limonoid aglycones, glucosinolates or hydrolysis productthereof, and organic isothiocyanates. Umami receptor ligands includeglutamate salts, glutamines, acetyl glycines, or aspartame. Fat receptorligands include linoleic acids, oleic acids, palmitates,oleoylethanolamides, mixed fatty acid emulsion, omega-3 fatty acids andN-acylphosphatidylethanolamine (NAPE). Bile acids include deoxycholicacids, taurocholic acids and chenodeoxycholic acids. In certainembodiments, the chemosensory receptor ligand is nonmetabolized. Incertain embodiments, the chemosensory receptor ligand is an agonist. Incertain embodiments, the chemosensory receptor ligand is an enhancer.

Provided herein is a method of modulating the hormonal profile of lowerintestine by administering a composition having at least onechemosensory receptor ligand to the lower intestine of a subject. In oneembodiment, the hormonal profile is that of GLP-1, Oxyntomodulin, andPeptide YY.

Provided herein is a method of modulating the hormonal profile of upperintestine by administering a composition having at least onechemosensory receptor ligand to the upper intestine of a subject. In oneembodiment, the hormonal profile is that of GLP-1, GLP-2, Oxyntomodulin,Peptide YY, GIP, Insulin C Peptide, glucagon, insulin, cholecystokinin(CCK), or any combination thereof.

Further provided herein is a method to sensitize lower intestinalchemosensory receptors by stimulating chemosensory receptors in theupper intestine.

Provided herein are methods of treating conditions associated with achemosensory receptor with the compositions described herein. Conditionsassociated with a chemosensory receptor include metabolic syndrome,insulin resistance, diabetes type I, diabetes type II, obesity, bingeeating, undesired food cravings, food addiction, a desire to reduce foodintake or to lose weight or maintain weight loss, anorexia, glucoseintolerance, gestational diabetes mellitus (GDM), dyslipidemia,post-prandial dyslipidemia, bone loss disorders, osteopenia,osteoporosis, muscle wasting disease, muscle degenerative disorders,polycystic ovary syndrome (PCOS), non-alcoholic fatty liver disease(NAFL), non-alcoholic steatohepatitis (NASH), depression, a mooddisorder, immune disorders of the gut (e.g., celiac disease), bowelirregularity, irritable bowel syndrome (IBS) and inflammatory boweldisease (IBD) including ulcerative colitis, Crohn's disease, and shortbowel syndrome. In some embodiments, the condition is obesity. In otherembodiments, the condition is diabetes. In further embodiments, thesubject is undergoing bariatric surgery. In yet other embodiments,methods provided herein further include administering a drug fordiabetes or obesity.

Also provided herein are methods for treating a disease, disorder ordefect in energy homeostasis in a subject comprising administering acomposition described herein. In one aspect, the composition is adaptedto release a therapeutically effective amount of a chemosensory ligandto one or more regions of the intestine.

INCORPORATION BY REFERENCE

All publications, patents, and patent applications mentioned in thisspecification are herein incorporated by reference to the same extent asif each individual publication, patent, or patent application wasspecifically and individually indicated to be incorporated by reference.

DETAILED DESCRIPTION OF THE INVENTION

The present invention relates to methods and compositions for treatingconditions associated with a chemosensory receptor, for example,metabolic conditions including obesity and diabetes, using a ligand orcombination of ligands that stimulates chemosensory receptors present oncells lining the gut. Binding of ligand(s) to these chemosensoryreceptors modulates the production of hormone molecules, e.g., GLP-1,GLP-2, oxyntomodulin, PYY, GIP, insulin C peptide, glycentin, glucagon,and/or CCK that are key regulators of energy and metabolic processessuch as glucose metabolism. The specific hormone(s) produced varydepending on the receptor(s) stimulated. Chemosensory receptor ligandsinclude receptor ligands that are metabolizable or can be metabolized asan energy source, e.g. food or metabolites, as well as receptor ligandsthat are nonmetabolized, e.g. tastants. Nonmetabolized chemosensoryreceptor ligands, as used herein, include ligands that are notsubstantially metabolized, i.e., ligands having insignificant caloricvalue.

In some embodiments, one or more nonmetabolized chemosensory receptorligands are used to modulate the secretion of hormone molecules andregulate metabolic processes. In other embodiments, a nonmetabolizedchemosensory receptor ligand(s) is combined with a metabolized ormetabolizable chemosensory receptor ligand(s). It is contemplated thatthe addition of one or more metabolized chemosensory receptor ligandsalong with activation of the enteroendocrine cell chemosensory receptorsby a nonmetabolized chemosensory receptor ligand(s), may result inenhanced stimulation of hormone release.

The present embodiments described herein additionally contemplatetargeting administration of chemosensory receptor ligands to specificsites throughout the gut. Enteroendocrine cells, e.g., L cells, K cells,and I cells, that each secrete a different set of metabolic hormones inresponse to chemosensory stimulation, occur throughout the length of theintestine. The concentrations and proportions of these enteroendocrinecell types are different in the various intestinal segments, and, asnoted above, each cell type has a different metabolic hormone expressionprofile. Targeted administration of the compositions of the invention tospecific intestinal segments, for example, through the use offormulations designed for release within one or more desired segments ofthe intestine, provides an additional level of control over the effectof such compositions, e.g., in the modulation of hormones involved inmetabolism.

The present embodiments described herein thus include a novel approachto treating important chemosensory receptor-associated conditions by,for example, modulating the secretion of metabolic hormones throughenteroendocrine chemosensory receptor activation. The embodimentsfurther include the capability to select combination therapies tailoredto the specific needs of individuals having varying hormone profiles.

Chemosensory Receptors

Mammalian chemosensory receptors and ligands are discussed, e.g., inU.S. Pat. App. Pub. Nos. 2008/0306053 and 2008/0306093, both titled“Modulation of Chemosensory Receptors and Ligands Associated Therewith,”and U.S. Pat. No. 7,105,650, titled “T2R taste receptors and genesencoding same.” Complete or partial sequences of numerous human andother eukaryotic chemosensory receptors are currently known (see, e.g.,Pilpel, Y. et al., Protein Science, 8:969 77 (1999); Mombaerts, P.,Annu. Rev. Neurosci., 22:487 50 (1999); EP0867508A2; U.S. Pat. No.5,874,243; WO 92/17585; WO 95/18140; WO 97/17444; WO 99/67282).

Sweet and Umami Receptors: In humans, different combinations of theT1Rs, a family of class C G-protein-coupled receptors, respond to sweetand umami taste stimuli. T1R2 and T1R3 reportedly recognize sweet tastestimuli. The T1R subunits that comprise the heteromeric sweet and umamitaste receptors are described by, e.g., Xu, et al., 2004, Proc Natl AcadSci USA 101: 14258-14263. Xu, et al., report that aspartame and neotamerequire the N-terminal extracellular domain of T1R2, G protein couplingrequires the C-terminal half of T1R2, and that cyclamate and lactisole,a sweet receptor inhibitor, require the transmembrane domain of T1R3.Their results suggest the presence of multiple sweetener interactionsites on this receptor.

T1R1 and T1R3 recognize umami taste stimulus L-glutamate. This responseis reportedly enhanced by 5′ ribonucleotides (Xu, et al., 2004).

Bitter Receptors: Bitter chemicals are detected by around 50 T2Rreceptor (GPCR) family members (Adler et al., 2000, Cell 100:693-702;Chandrashekar et al., 2000, Cell 100:703-711; Matsunami et al., 2000,Nature 404:601-604). Certain T2Rs and methods for expressing them aredescribed in, e.g., U.S. Pat. App. Pub. No. 2008/0306053 and U.S. Pat.No. 7,105,650. Haplotypes of many of the bitter receptor have also beenidentified which confer differences in the sensitivity of individuals toparticular bitter tastant (Pronin et al., 2007, Current Biology 17(6):1403-1408).

Bile Receptors: There are multiple bile acid receptors. The bile acidreceptor having subunits Gpbar1 and M-Bar is reportedly involved in theinfluence of bile acids on fat solubilization, cholesterol maintenance,and bile acid homeostasis (Maruyama, et al., 2006, J. Endocrinol. 191,197-205). Maruyama, et al., report a possible role for Gpbar in energyhomeostasis. Kawamata, et al. (“A G protein-coupled receptor responsiveto bile acids” J. Biol. Chem. 278, 9435-9440, 2003), report a possiblerole for bile acid receptor TGR5 in the suppression of macrophagefunction.

Sour and Salty Taste Receptors: A number of candidate receptors andtransduction mechanisms for sensing sour and salty taste have beenproposed (Miyamoto et al., 2000, Prog. Neurobiol. 62:135-157). Forexample, acid-sensing ion channel-2 (ASIC2) is proposed to function as asour receptor in the rat (Ugawa et al, 2003, J. Neurosci. 23:3616-3622;Ugawa et al., 1998, Nature 395:555-556). HCN1 and HCN4, members ofhyperpolarization-activated cyclic nucleotide gated channels (HCNs) arealso candidate sour receptor channels (Stevens et al., 2001, Nature413:631-635). Among TRP channel families, members of the PKD family(polycystic kidney disease, also called TRPP or polycystins) have beenreported to possess unique properties (Delmas et al., 2004, Biochem.Biophys. Res. Commun. 322:1374-1383; Nauli and Zhou, 2004, Bioessays26:844-856). Two TRP channel members, PKD 1L3 (Genbank Accession Nos.AY1 64486, murine, nucleic acid, AA032799 murine, amino acid, AY1 64485,human, nucleic acid, and AA032798, human, amino acid), and PKD2L1(Genbank Accession Nos. NM_181422, murine, nucleic acid, NP_852087,murine, amino acid, NM_016112, human, nucleic acid and NP_057196, human,amino acid, are reportedly specifically expressed in a subset of tastereceptor cells that do not correspond to bitter, sweet or umami sensingcells. The proteins are localized at the apical tip of taste cells wheretastants are detected. PKD1L3 and PKD2L1 heteromer formation is requiredfor functional cell surface expression and whenever PKD1L3 and PKD2L1are expressed in heterologous cells they are activated by soursolutions. Therefore, it is contemplated PKD 1L3 and PKD2L1 functiontogether as sour taste receptors in mammals, although an understandingof the mechanism is not necessary to practice the present invention andthe present invention is not limited to any particular mechanism ofaction.

Fat Receptors: Fat receptor or fatty acid receptor as used herein meansany transporter receptor or other molecule that binds to fats and/orfatty acids that are ingested. Chemosensory receptors for fat have notbeen well characterized, though there is possible involvement of fattyacid transport proteins known to be present in the gastrointestinaltract. The mouse fatty acid transporter protein CD36 has been reportedto be a potential fat taste receptor (Laugerette, et al., 2005, “CD36involvement in orosensory detection of dietary lipids, spontaneous fatpreference, and digestive secretions,” Journal of Clinical Investigation115(11): 3177-84). In rat, CD36 has been found to be expressed at higherlevels in proximal than distal intestinal mucosa (Chen, et al., 2001,“Gut expression and regulation of FAT/CD36: possible role in fatty acidtransport in rat enterocytes,” Am J Physiol Endocrinol Metab.281(5):E916-23). More recently, a number of GPCRs which were previouslyclassified as orphan receptors have been shown to respond to lipidligands, including fatty acids and several have been identified ascandidates for fat receptors in taste.

When a ligand binds to a GPCR, the receptor presumably undergoes aconformational change leading to activation of the G Protein. G Proteinsare comprised of three subunits: a guanyl nucleotide binding a subunit,a β subunit, and a γ subunit. G Proteins cycle between two forms,depending on whether GDP or GTP is bound to the α subunit. When GDP isbound, the G Protein exists as a heterotrimer: the Gαβγ complex. WhenGTP is bound, the α subunit dissociates from the heterotrimer, leaving aGβγ complex. When a Gαβγ complex operatively associates with anactivated G Protein-Coupled Receptor in a cell membrane, the rate ofexchange of GTP for bound GDP is increased and the rate of dissociationof the bound Gα subunit from the Gαβγ complex increases. The free Gαsubunit and Gβγ complex are thus capable of transmitting a signal todownstream elements of a variety of signal transduction pathways. Theseevents form the basis for a multiplicity of different cell signalingphenomena, including for example the signaling phenomena that areidentified as neurological sensory perceptions such as taste and/orsmell. (See, e.g., U.S. Pat. No. 5,691,188.) GP120, a GPCR correspondingto an fatty acid receptor, has also been identified in the taste buds ofmice and, furthermore, ω3 fatty acids have been shown to mediateanti-inflammatory effects and reverse insulin resistance in obese micevia their actions on GP120 present in macrophages (Oh et al., 2010, Cell142(5): 687-698; Satiel, Cell 142(5): 672-674; also see Matsumura etal., 2009, Neurosci Lett 450: 186-190).

Hormones

The embodiments described herein include compositions and methods formodulating the levels of circulating enteroendocrine cell hormones,including, but not limited to, GLP-1, GLP-2, GIP, oxyntomodulin, PYY,cholecystokinin (CCK), glycentin, insulin, glucagon, insulin C peptide,ghrelin, etc., such compositions and methods comprising administering atleast one chemosensory receptor ligand to a subject to treat a conditionassociated with a chemosensory receptor. Hormone modulation can beachieved by administering a composition comprising a chemosensoryreceptor ligand, including an agonist, antagonist, modifier, enhancer orcombination thereof acting on a sweet-taste receptor, an umami receptor,a bitter receptor, a fatty acid receptor, and/or a bile acid receptor.

In particular embodiments, a combination of one or more agonists of thesweet, umami, bitter, free fatty acid, and bile acid receptors willsimulate the synchronous release of important hormones and neuralsignals from the enteroendocrine cells and thus facilitate theassimilation and disposition of meal nutrients. In additionalembodiments, a combination of one or more agonists of the sweet, umami,bitter, free fatty acid, and bile acid receptors suppresses ghrelinsynthesis, activity or action, or its post-translational modification(Ghrelin Octonoyl Acyl Transferase activity or GOAT) and/or ghrelinsecretion or release from oxyntic cells in the stomach. It is importantto note that some of these hormones may not exhibit major effects whenadministered alone but may perform additively and/or synergisticallywhen released together. For example, PYY 3-36 as a single therapy hasdisappointed in the clinic (Nastech Press Release). Therefore, inembodiments the invention provides coordinate and synchronous release ofgut hormones in concert while not ascribing a specific activity tomerely a single hormone. Enteroendocrine cell (e.g., L cells, K cellsand I cells) stimulation by nutrients reportedly alters release of oneor more of the following known hormones: GLP-1, GLP-2, GIP,oxyntomodulin, PYY, CCK, insulin, glucagon, insulin C peptide,glycentin, ghrelin. Nutrients may also alter release ofyet-to-be-characterized hormones released from enteroendocrine cells.This modulation in hormone release can result in beneficial therapeuticeffects, for example, better glucose control in the treatment ofdiabetes and related disorders (prediabetes, polycystic ovary disease),inflammatory bowel disorders, bowel damage and osteoporosis (e.g.,through the release of GLP-2), lowering of circulating lipids in thetreatment of hyperlipidemia, fatty liver disease, and reduced foodintake and the regulation of energy homeostasis in the treatment ofobesity (weight loss). Administering a combination of one or moreagonists of the sweet, umami, bitter, free fatty acid, and bile acidreceptors components along with a DPP-IV inhibitor can increase thetherapeutic effect, since GLP-1, PYY, GLP-2 and GIP are rapidlyeliminated by DPP-IV.

In vivo results consistent with the use of sweet, umami, free fattyacid, and bile acid receptors to increase GLP-1 levels include:

The release of GLP-1 was reported during intraduodenal glucose deliveryin humans. (See, e.g., Kuo, et al., 2008, “Transient, early release ofglucagon-like peptide-1 during low rates of intraduodenal glucosedelivery,” Regul Pept 146, 1-3.)

An increase in postprandial GLP-1 levels was observed afteradministration of the alpha-glucosidase inhibitor miglitol in humans.(See, e.g., Lee, et al., 2002, “The effects of miglitol on glucagon-likepeptide-1 secretion and appetite sensations in obese type 2 diabetics,”Diabetes Obes Metab 4, 329-335.)

In rats, the increase in GLP-1 after administration of miglitol wassynergistic with administration of a DPP-IV inhibitor (Goto et al.,2008, Poster P-470 ADA).

Inulin-type fructans (non-digestible fructose polymers) reportedlystimulated GLP-1 secretion. (See, e.g., Delzenne, et al., 2007,“Modulation of glucagon-like peptide 1 and energy metabolism by inulinand oligofructose: experimental data,” J Nutr 137, 2547S-2551S andNiness, et al., 1999, “Inulin and oligofructose: what are they?” J Nutr129, 1402S-1406S.)

Administration of glutamate, an umami agonist, to rats resulted indecreased weight gain and reduced abdominal fat. (See, e.g., Kondoh, etal., 2008, “MSG intake suppresses weight gain, fat deposition, andplasma leptin levels in male Sprague-Dawley rats,” Physiol Behav 95,135-144.)

Oral administration of free fatty acids to mice resulted in increasedportal and systemic GLP-1 concentrations. (See, e.g., Hirasawa, et al.,2005, “Free fatty acids regulate gut incretin glucagon-like peptide-1secretion through GPR120,” Nat Med 11, 90-94.)

G protein-coupled bile acid receptor 1 deficient mice showedsignificantly higher fat accumulation and weight gain relative tocontrol mice. (See, e.g., Maruyama, et al., 2006, cited above.)

In vivo studies with rat jejunum perfused with sucralose and glutamateshowed that sweet and umami receptors regulate glucose, peptide andglutamate absorption. (See, e.g., Mace, et al., 2008, “An energy supplynetwork of nutrient absorption coordinated by calcium and T1R tastereceptors in rat small intestine,” J Physiol.)

Bile acids provided to humans via rectal administration caused releaseof PYY. (See, e.g., Adrian, et al., 1993, “Deoxycholate is an importantreleaser of peptide YY and enteroglucagon from the human colon,” Gut34(9):1219-24.)

While there are reports of metabolized ligands to the variouschemosensory receptors having effects to release gut hormones, it hasbeen reported that nonmetabolized chemosensory receptor ligands may noteffect gut hormone release. Frank Reimann. Molecular mechanismsunderlying nutrient detection by incretin-secreting cells.” Int Dairy J.2010 April; 20(4): 236-242. doi: 10.1016/j.idairyj.2009.11.014.

For example, instillation of sucralose (a nonmetabolized sweetener) intothe duodenum of humans reportedly had no effect on gut hormone releasewhile instillation of metabolized sugars did. Ma J, et al., “Effect ofthe artificial sweetener, sucralose, on gastric emptying and incretinhormone release in healthy subjects,” CK Am J Physiol Gastrointest LiverPhysiol. 2009 April; 296(4):G735-9. Epub 2009 Feb. 12. Other studies inrats reportedly showed no effect of the nonmetabolized sweeteners,sucralose and stevia, to cause gut hormone release, while dextrose didhave an effect. Fujita Y, et al., “Incretin Release from Gut is AcutelyEnhanced by Sugar but Not by Sweeteners In Vivo,” Am J PhysiolEndocrinol Metab. 2008 Dec. 23. [Epub ahead of print]; Reimann F., etal., “Glucose sensing in L-cells: a primary cell study,” CellMetabolism. 2008; 8:532-539. Other reports in humans reported noalterations of gut hormones in the circulation after administration ofstevia or rebaudioside A, which are both nonmetabolized sweeteners.Gregersen, S., et al., “Antihyperglycemic Effects of Stevioside in type2 diabetic subjects,” 73 Metabolism, Vol 53, No 1 (January), 2004: pp73-76.

Additionally, reports in humans or animals have suggested thatnon-nutritive sweeteners may not cause weight loss. See e.g., Maki, K.C., et al., “Chronic consumption of rebaudioside A, a steviol glycoside,in men and women,” Food Chem Toxicol. 2008 July; 46 Suppl 7:S47-53. Epub2008 May 16; Yang, Q. “Gain weight by ‘going diet?’” Artificialsweeteners and the neurobiology of sugar cravings,” Neuroscience 2010.Yale J Biol Med. 2010 June; 83(2):101-8; Ludwig, D S, “Artificiallysweetened beverages: cause for concern,” JAMA. 2009 Dec. 9;302(22):2477-8). Other reports suggest that non-nutritive sweeteners maybe instrumental in causing weight gain or effects on hunger or satiety.Richard Mattes. Effects of Aspartame and Sucrose on Hunger and EnergyIntake in Humans. Physiology & Behavior, Vol. 47, pp. 1037-1044. Effectsof Aspartame and Sucrose on Hunger and Energy Intake in Humans.

Chemosensory Receptor Ligands

Chemosensory receptor ligands include metabolized chemosensory receptorligands that can be metabolized as an energy source, e.g. food ormetabolites, as well as nonmetabolized chemosensory receptor ligandsthat are not metabolized as an energy source, e.g. tastants. The termnonmetabolized chemosensory receptor ligands, as used herein, includeschemosensory receptor ligands that are metabolized to a small degree butare not metabolized substantially. That is, nonmetabolized chemosensoryreceptor ligand includes ligands that have insignificant caloric value.Chemosensory receptor ligands include agonists, antagonists, modifiers,and enhancers as well as other compounds that modulate chemosensoryreceptors. Many chemosensory receptor ligands are known in the art andhave been reported in the literature.

Non-limiting examples of umami receptor ligands include glutamate salts,glutamines, acetyl glycines, and aspartame. Many more umami receptorligands other than those listed herein and in the cited manuscripts, areknown to those of skill in the art, and still more can be identifiedusing methods known in the art and described herein.

Non-limiting examples of fat receptor ligands include linoleic acids,oleic acids, palmitates, oleoylethanolamides, omega-3 fatty acids, mixedfatty acid emulsion, and N-acylphosphatidylethanolamine (NAPE),myristoleic acid, palmitoleic acid, alpha-linolinic acid, arachidonicacid, eicosapentaenoic acid, erucic acid, and docosahexaenoic acid. Manymore fat receptor ligands other than those listed herein and in thecited manuscripts, are known to those of skill in the art, and stillmore can be identified using methods known in the art and describedherein.

Bile acids include cholic acids, deoxycholic acids, taurocholic acidsand chenodeoxycholic acids. Many more bile acid receptor ligands otherthan those listed herein and in the cited manuscripts, are known tothose of skill in the art, and still more can be identified usingmethods known in the art and described herein.

Non-limiting bitter receptor ligands include flavanones, flavones,flavonols, flavans, phenolic flavonoids, isoflavones, limonoidaglycones, glucosinolates or hydrolysis product thereof, caffeine,quinine, extracts of Momordica charantia (bitter melon), andisothiocyanates. Certain bitter tastants are described, e.g., inDrewnowski and Gomez-Cameros, American Journal of Nutrition, 72 (6):1424 (2000). Many more bitter receptor ligands other than those listedherein and in the cited manuscripts, are known to those of skill in theart, and still more can be identified using methods known in the art anddescribed herein. Exemplary bitter phytonutrients in common plant foodsthat can be bitter receptor ligands are listed in the following table.

Phytonutrient class Typical component Taste quality Food source Phenoliccompounds Flavanones Naringin Bitter Grapefruit, flavedo Grapefruit,albedo Grapefruit, pith Grapefruit, seeds Immature grapefruit Grapefruitjuice Oroblanco juice Melogold juice Flavones Tangeretin Bitter Orangefruit Orange juice Juice from concentrate Nobiletin Bitter Orange fruitOrange juice Juice from concentrate Sinensetin Bitter Orange fruitOrange juice (fresh) Juice from concentrate (frozen) Juice fromconcentrate Pure juice Flavonols Quercetin Bitter Grapefruit juice Lemonjuice Endive Fresh hops Wine Black tea infusion Oolong tea infusionGreen tea infusion Flavans Catechin Bitter Red wine Green tea infusionOolong tea infusion Black tea infusion Epicatechin Bitter Red wineLow-fat cocoa powder Instant cocoa powder Green tea infusion Oolong teainfusion Black tea infusion Epicatechin gallate Bitter and astringentGreen tea infusion Oolong tea infusion Black tea infusionEpigallocatechin Bitter with sweet Green tea infusion aftertaste Oolongtea infusion Black tea infusion Epigallocatechin Bitter with sweet Greentea infusion gallate aftertaste Oolong tea infusion Black tea infusionPhenolic flavonoids Catechin mono- and Bitter Red wine polymers MW < 500Rosé wine Catechin polymers Astringent Red wine MW > 500 (tannins) Applecider Polyphenols Astringent and bitter Low-fat cocoa power Instantcocoa powder Isoflavones Genistein and daidzein Bitter or astringentSoybeans Toasted, defatted soy flakes Textured soy protein Breakfastpatties Tofu Genistin Astringent Soy seeds Daidzin Triterpenes Limonoidaglycones Limonin Bitter Lemon juice Orange juice Grapefruit juiceTangerine juice Grapefruit, flavedo Grapefruit, albedo Grapefruit, pithGrapefruit, seeds Nomilin Bitter Grapefruit juice Oroblanco juiceMelogold juice Limonin glucoside Tasteless Grapefruit juice Lemon juiceOrganosulfur compounds Glucosinolates Sinigrin Bitter Cabbage Brusselssprouts Cauliflower Turnip or swede Calabrese Broccoli Collards KaleMustard greens Progoitrin Bitter Brussels sprouts Cabbage CauliflowerTurnip or swede Calabrese Glucobrassicin Bitter Brussels sproutsHydrolysis product of Goitrin 5-vinyl-2- Bitter Aqueous extract ofglucosinolates oxazolidine thione Brussels sprouts Cabbage, pithCabbage, cambial cortex Cabbage, leaf IsothiocyanatesAllyl-isothiocyanate Acrid mustard oils; Cabbage, pith pungent orlachrymatory Cabbage, cambial cortex Cabbage, leaf 3-Methyl- Acridmustard oils Cabbage, pith sulfinylpropyl isothiocyanate Cabbage,cambial cortex Cabbage, leaf Benzyl isothiocyanate Acrid mustard oils;Cabbage, cambial cortex garlic-like Cabbage, leaf 4-Methylsulfinyl butylAcrid mustard oils Cabbage, pith isothiocyanate Cabbage, cambial cortexCabbage, leaf Phenylethyl Acrid, irritant, or Cabbage, pithisothiocyanate lachrymatory Cabbage, cambial cortex Cabbage, leaf

Non-limiting sweet receptor ligands include metabolized sugars (glucose,fructose, etc.) and nonmetabolized sweeteners (sucralose, aspartame,rebaudiosides, steviosides (natural sweeteners extracted from the steviaplant), neotame, acesulfame-K, saccharin and the like). Sweet receptorligands can also affect other chemosensory receptors. For example,aspartame is contemplated to play a role in responses relating to bothsweet receptor activation and amino acid metabolism. Further sweetreceptor ligands are described, e.g., by Kim, et al., 2002, “Highlysweet compounds of plant origin,” Arch Pharm Res. 25(6):725-46 andKinghorn, et al., 1989, “Intensely sweet compounds of natural origin,”Medicinal Research Reviews 9(1):91-115. Many more sweet receptor ligandsother than those listed herein and in the cited manuscripts, are knownto those of skill in the art, and still more can be identified usingmethods known in the art and described herein. Exemplary sweet receptorligands of plant origin are listed in the following table adapted fromKim et al., 2002.

Sweetness/ Compound type/name Plant name potency^(a) MONOTERPENEPerillartine (10)^(b) Perilla frutescens (L.) Britton (Labiatae) 370SESQUITERPENES Bisabolanes (+)-H-Hernandulcin (11) Lippia dulcis Trey.(Verbenaceae) 1,500 4β-Hydroxyhernandulcin (12) L. dulcis N.S.^(c)Acyclic glycoside Mukurozioside IIb (13) Sapindus rarak DC.(Sapindaceae) ca. 1 DITERPENES Diterpene acid4β,11α-Dimethyl-1,2,3,4,5,10-hexahydro- Pine tree 1,300-fluorene-4α,6α-dicarboxylic acid (14)^(b) 1,800d ent-Kaurene glycosidesDulcoside A (15) Stevia rebaudiana (Bertoni) Bertoni 30 (Compositae)Rebaudioside A (4) S. rebaudiana 242 Rebaudioside B (16) S. rebaudiana150 Rebaudioside C (17) S. rebaudiana 30 Rebaudioside D (18) S.rebaudiana 221 Rebaudioside E (19) S. rebaudiana 174 Rebaudioside F (20)S. rebaudiana N.S.^(c) Rubusoside (21) Rubus suavissimus S. Lee(Rosaceae) 115 Steviolbioside (22) S. rebaudiana 90 Steviol13-0-β-D-glucoside (23) R. suavissimus N.S.^(c) Stevioside (5) S.rebaudiana 210 Suavioside A (24) R. suavissimus N.S.^(c) Suavioside B(25) R. suavissimus N.S.^(c) Suavioside G (26) R. suavissimus N.S.^(c)Suavioside H (27) R. suavissimus N.S.^(c) Suavioside I (28) R.suavissimus N.S.^(c) Suavioside J (29) R. suavissimus N.S.^(c) Labdaneglycosides Baiyunoside (30) Phlomis betonicoides Diels (Labiatae) 500Phlomisoside I (31) P. betonicoides N.S.^(c) Gaudichaudioside A (32)Baccharis gaudichaudiana DC. 55 (Compositae) TRITERPENES Cucurbitaneglycosides Bryodulcoside Bryonia dioica Jacq. (Cucurbitaceae) N.S.^(c)Bryoside (33) B. dioica N.S.^(c) Bryonoside (34) B. dioica N.S.^(c)Carnosifloside V (35) Hemsleya camosiflora C.Y. Wu et Z.L. 51 Chen(Cucurbitaceae) Carnosifloside VI (36) H. carnosiflora 77 Mogroside IV(37) Siraitia grosvenorii (Swingle) Lu & 233-392^(d) Zhang^(e)(Cucurbitaceae) Mogroside V (2) S. grosvenorii 250-425^(d)11-OxomogrosideV (38) Siraitia siamensis Craib (Cucurbitaceae) N.S.^(c)Scandenoside R6 (39) Hemsleya panacis-scandens C.Y. Wu et 54 Z.L. Chen(Cucurbitaceae) Scandenoside R11 (40) H. panacis-scandens N.S.^(c)Siamenoside I (41) Siraitia grosvenorii, S. siamensis 563 Cycloartaneglycosides Abrusoside A (42) Abrus precatorius L.; A. fruticulosus Wall30 et W. & A. (Leguminosae) Abrusoside B (43) A. precatorius, A.fruticulosus 100 Abrusoside C (44) A. precatorius; A. fruticulosus 50Abrusoside D (45) A. precatorius; A. fruticulosus 75 Abrusoside E (46)A. precatorius N.S.^(c) Dammarane glycosides Cyclocarioside A (47)Cyclocarya paliurus (Batal.) Iljinsk 200 (Juglandaceae) Cyclocaryoside I(48) C. paliurus 250 Gypenoside XX (49) Gynostemma pentaphyllum MakinoN.S.^(c) (Cucurbitaceae) Oleanane glycosides Albiziasaponin A (50)Albizia myriophylla Benth. 5 (Leguminosae) Albiziasaponin B (51) A.myriophylla 600 Albiziasaponin C (52) A. myriophylla N.S.^(c)Albiziasaponin D (53) A. myriophylla N.S.^(c) Albiziasaponin E (54) A.myriophylla N.S.^(c) Apioglycyrrhizin (55) Glycyrrhiza inflata Batal.(Leguminosae) 300 Araboglycyrrhizin (56) G. inflata 150 Glycyrrhizin (1)Glycyrrhiza glabra L. (Leguminosae) 93-170^(d) Periandrin I (57)Periandra dulcis Mart.; P. mediterranea 90 (Vell.) Taub. (Leguminosae)Periandrin II (58) P. dulcis, P. mediterranea 95 Periandrin III (59) P.dulcis, P. mediterranea 92 Periandrin IV (60) P. dulcis, P. mediterranea85 Periandrin V (61) P. dulcis 220 Secodammarane glycosidesPterocaryoside A (62) Pterocarya paliurus Batal. (Juglandaceae) 50Pterocaryoside B (63) P. paliurus 100 STEROIDAL SAPONINS Osladin (64)Polypodium vulgare L. (Polypodiaceae) 500 Polypodoside A (65) Polypodiumglycyrrhiza DC. Eaton 600 (Polypodiaceae) Polypodoside B (66) P.glycyrrhiza N.S.^(c) Telosmoside A₈ (67) Telosma procumbens (Hence)Merr. N.S.^(c) (Asclepiadaceae) Telosmoside A₉ (68) T. procumbensN.S.^(c) Telosmoside A₁₀ (69) T. procumbens N.S.^(c) Telosmoside A₁₁(70) T. procumbens N.S.^(c) Telosmoside A₁₂ (71) T. procumbens N.S.^(c)Telosmoside A₁₃ (72) T. procumbens N.S.^(c) Telosmoside A₁₄ (73) T.procumbens N.S.^(c) Telosmoside A₁₅ (74) T. procumbens 1000 TelosmosideA₁₆ (75) T. procumbens N.S.^(c) Telosmoside A₁₇ (76) T. procumbensN.S.^(c) Telosmoside A₁₈ (77) T. procumbens N.S.^(c) PHENYLPROPANOIDStrans-Anethole (78)^(f) Foeniculum vulgare Mill. (Umbelliferae) 13Illicium verum Hook F. (Illiciaceae) Myrrhis odorata Scop.(Umbelliferae) Osmorhizalongistylis DC. (Umbelliferae) Piper marginatumJacq. (Piperaceae) Tagetes filicifolia Lag. (Compositae)Trans-Cinnamaldehyde (79) Cinnamomum osmophloeum Kanehira 50 (Lauraceae)DIHYDROISOCOUMARIN Phyllodulcin^(g) (3) Hydrangea macrophylla Seringevar. 400 thunbergii (Siebold) Makino (Saxifragaceae) FLAVONOIDSDihydrochalcone glycosides Glycyphyllin (80) Smilax glycyphylla Sm.(Liliaceae) N.S.^(c) Naringin dihydrochalcone^(c) (81) Citris paradisiMacfad. (Rutaceae) 300 Neohesperidin dihydrochalcone^(c) (82) Citrusaurantium L. 1,000 Phlorizin (83) Symplocos lancifolia Sieb. Et Zucc.N.S.^(c) (Symplocaceae) Trilobatin (84) Symplocos microcalyx HayataN.S.^(c) Dihydroflavonols and Dihydroflavonols glycosides3-Acetoxy-5,7-dihydroxy-4′- Aframomum hanburyi K. Schum. N.S.^(c)methoxyflavanone (85) (Zingiberaceae) 2R,3R-(+)-3-Acetoxy-5-7-4′- A.hanburyi N.S.^(c) trihydroxyflavanone (86) Dihydroquercetin 3-O-acetate4′-methyl Tessaria dodoneifolia (Hook. & Am.) 400 ether^(c) (87) Cabrera(Compositae) (2R,3R)-Dihydroquercetin 3-O-acetate (88) T. dodoneifolia;Hymenoxys turneri K. 80 Parker (Compositae)(2R,3R)-2,3-Dihydro-5,7,3′,4′-tetrahydroxy- H. turneri 256-methoxy-3-O-acetylflavonol (89)(2R,3R)-2,3-Dihydro-5,7,3',4'-tetrahydroxy- H. turneri 156-methoxyflavonol (90) (2R,3R)-2,3-Dihydro-5,7,4′-trihydroxy-6- H.turneri 20 methoxy-3-O-acetylflavonol (91) Huangqioside E. (92)Engelhardtia chrysolepis Hance N.S.^(c) (Juglandaceae) Neoastilbin (93)E. chrysolepis N.S.^(c) PROANTHOCYANIDINS Cinnamtannin B-1 (94)Cinnamomum sieboldii Meisner N.S.^(c) (Lauraceae) Cinnamtannin D-1 (95)C. sieboldii N.S.^(c) Selligueain A (96) Selliguea feei Bory(Polypodiaceae) 35 Unnamed (97) Arachniodes sporadosora Nakaike;N.S.^(c) A. exilis Ching (Aspidiaceae) Unnamed (98) A. sporadosora; A.exilis N.S.^(c) BENZO[b]INDENO[1,2-d]PYRAN Hematoxylin (99) Haematoxyloncampechianum L. 120 (Leguminosae) AMINO ACID Monatin (100) Schlerochitonilicifolius A. Meeuse 1,200- (Acanthaceae) 1,400^(d) PROTEINS BrazzeinPentadiplandra brazzeana Baillon 2,000 (Pentadiplandraceae) CurculinCurculigo latifolia Dryand. 550 (Hypoxidaceae) Mabinlin Capparismasaikai Levl. (Capparidaceae) N.S.^(c) Monellin Dioscoreophyllumcumminsii (Stapf) 3,000 Diels. (Menispermaceae) Pentadin Pentadiplandrabrazzeana Bailon 500 (Pentadiplandraceae) Thaumatin Thaumatococcusdanielli (Bennett) 1,600 Benth. (Marantaceae) ^(a)Values of relativesweetness on a weight comparison basis to sucrose (=1.0)^(b)Semisynthetic derivative of natural product. ^(c)N.S. = Sweetnesspotency not given. ^(d)Relative sweetness varied with the concentrationof sucrose. ^(e)Formerly named Momordica grosvenorii Swingle andThladiantha grosvenorii (Swingle) C. Jeffrey (Kinghorn and Kennelly,1995). ^(f)Identified as a sweet-tasting constituent of these sixspecies. However, this compound has a wider distribution in the plantkingdom. ^(g)The plant of origin may be crushed or fermented in order togenerate phyllodulcin

Many more chemosensory receptor ligands in addition to those listedherein and the cited manuscripts are known to those of skill in the art,and still more can be identified using methods known in the art anddescribed herein.

In some embodiments, a nonmetabolized chemosensory receptor ligand, e.g.a tastant, is administered alone. In certain instances, theadministration of one or more nonmetabolized chemosensory ligands canresult in modulation of a hormone described herein. For example,sucralose is administered by itself or in conjunction with saccharin.

In other embodiments, a nonmetabolized chemosensory receptor ligand(s)is co-administered with a metabolized chemosensory receptor ligand(s),e.g. a metabolite. For example, a combination of sweet receptor tastantand a cognate metabolite could be sucralose and glucose. Othermetabolized sweet receptor ligands include, but are not limited to,fructose and galactose.

Combining a nonmetabolized chemosensory receptor ligand (e.g., atastant) with a metabolized chemosensory receptor ligand (e.g., ametabolite) may in cases enhance the resulting modulation of a hormone.In related embodiments, combining a nonmetabolized ligand for onereceptor with a metabolized ligand for a different receptor enhances theresulting modulation of hormone expression. In some embodiments,stimulating L cells with different combinations of nonmetabolizedligands and metabolized ligands results in different hormonal expressionprofiles. Certain profiles are more desirable depending on the conditionto be treated or even the particular individual to be treated.

The desired effects on treatment of a condition or modulation of hormonelevels can be tailored by the number of chemosensory receptor ligandsadministered to a subject. In some embodiments, two chemosensoryreceptor ligands are administered to a subject. In other embodiments,three chemosensory receptor ligands are administered to a subject. Inyet other embodiments, four chemosensory receptor ligands areadministered to a subject. In yet other embodiments, five chemosensoryreceptor ligands are administered to a subject. In further embodiments,six or more chemosensory receptor ligands are administered to a subject.When multiple ligands are administered to a subject, the ligands can bein the same or different compositions. Multiple chemosensory receptorligands can each target different receptor types or many or all theligands can target one receptor type. For example, in a fivechemosensory receptor ligand composition, three ligands may target thesweet receptor, one ligand for the bitter receptor, and one ligand forthe umami receptor. Any combination is contemplated in the embodimentsherein.

In most endocrine cell systems (e.g., the beta cell of the islet ofLangerhans), for an appropriate secretory level of a hormone to occurthe cell needs to sense the stimulus (in case of the beta cell,glucose), and in the case of nutrient-driven hormonal release,metabolism of the sensed nutrient is required for full secretoryactivation. It is recognized that both sensing and metabolism can elicitsecretory release of hormone. For example, in the case of calcium, whichis not a nutrient, sensing is sufficient for parathyroid hormonerelease. Thus, for full enteroendocrine activation it may be importantthat a nutrient is both sensed by the appropriate taste receptor andmetabolized.

In certain embodiments, sweet receptor agonism will be achieved bycoadministration of a composition comprising a sweet receptor agonist(e.g. sucralose, aspartame or stevioside, etc.) and an amount ofD-glucose, e.g., between 0.1 to 10 mg/kg/min. Depending on the hormoneof interest, co-administration may produce a more pronounced effect onhormonal release than either the tastant or glucose alone.

In further embodiments, a chemosensory receptor modifier is administeredwith a chemosensory receptor ligand to alter or change the activity of areceptor toward the ligand. In yet further embodiments a chemosensoryreceptor enhancer is administered with a chemosensory receptor ligand toenhance, potentiate or multiply the effect of the ligand. For example, asweet receptor enhancer can be administered with a sweet receptorligand, e.g., saccharin, to increase the sweetness potency and/orenhance hormone modulation. In certain instances, modifiers and/orenhancers are administered prior to administration of a chemosensoryreceptor ligand enhance, potentiate or multiply the effect of theligand. In other instances, modifiers and/or enhancers are administeredwith a chemosensory receptor ligand together to enhance, potentiate ormultiply the effect of the ligand. In yet further embodiments, achemosensory receptor enhancer is administered along with food or priorto food. The food serves as a source of chemosensory receptor ligandsthat can have their effects enhanced, potentiated or multiplied. Forexample, a sweet receptor enhancer can be administered prior toingestion of a sweet food such as a candy bar. Modulation andenhancement of chemosensory receptors by modulators and enhancers mayproduce a more pronounced effect on hormonal release than by achemosensory receptor or food alone.

Identification of Chemosensory Receptor Ligands

A number of assays known in the art and described in the literature canbe used to assay for taste transduction. For example, U.S. Pat. No.7,105,650, describes in vitro binding assays, fluorescence polarizationassays, solid state and soluble high throughput assays, computer basedassays, cell-based binding assays, and assays using transgenic animalsthat express taste receptors.

Human gastrointestinal cells or cell membranes can be used to test forcompounds that interact with taste signaling proteins and/orgastrointestinal protein hormones, neurotransmitters, or solublemediators involved in metabolism, digestion or appetite either directlyor indirectly, e.g., tastants, activators, inhibitors, enhancers,stimulators, agonists, antagonists, modulators and mimics. Assays fortaste modulation can be used wherein the taste signaling protein(s)and/or gastrointestinal protein hormone(s), neurotransmitter(s), orsoluble mediator(s) involved in metabolism, digestion or appetite actsas a direct or indirect reporter molecule(s) for the effect of acompound on signal transduction. Human gastrointestinal cells or theirmembranes can be used for such assays, e.g., to measure or detectchanges in levels of the one or more taste signaling proteins and/or theone or more gastrointestinal protein hormones, neurotransmitters orsoluble mediators synthesized or secreted by the cell, or to detect ormeasure changes in membrane potential, current flow, ion flux,transcription, phosphorylation, dephosphorylation, signal transduction,receptor-ligand interactions, second messenger concentrations, etc.

A modulator of taste transduction can be identified by contacting ahuman gastrointestinal cell or its membrane with a test compound,wherein the cell or membrane comprises one or more taste signalingproteins, evaluating the compound's effect on taste transduction. Thehuman gastrointestinal cells or their membranes can be used in anindirect reporter assay to detect whether a test compound affects tastetransduction and/or signal transduction of one or more gastrointestinalprotein hormones, neurotransmitters or soluble mediators involved inmetabolism (see, e.g., Mistili & Spector, 1997, Nature Biotechnology,15, 961-64).

Gastrointestinal cells or their membranes can be used to assay thebinding of a test compound that affects signal transduction by studying,e.g., changes in spectroscopic characteristics (e.g., fluorescence,absorbance, refractive index) or hydrodynamic (e.g., shape),chromatographic or solubility properties. Human gastrointestinal cellsor their membranes can be used to examine the effect of a compound oninteractions between a receptor and a G protein. For example, binding ofa G protein to a receptor or release of the G protein from the receptorcan be examined. In the absence of GTP, an activator will lead to theformation of a tight complex of all three subunits of the G protein withthe receptor. This complex can be detected in a variety of ways, asnoted above. Such an assay can be modified to search for inhibitors oftaste transduction or inhibitors of signal transduction of one or moregastrointestinal protein hormones, neurotransmitters or solublemediators. For example, an activator could be added to the receptor andG protein in the absence of GTP such that a tight complex forms, whichcould then be screened for inhibitors by studying dissociation of thereceptor-G protein complex. In the presence of GTP, release of the alphasubunit of the G protein from the other two G protein subunits serves asa criterion of activation.

An activated or inhibited G protein will in turn influence downstreamsteps of the signal transduction pathway, affecting, e.g., theproperties of target enzymes, channels and other effectors. Examples ofdownstream steps include activation of cGMP phosphodiesterase bytransducin in the visual system, adenylyl cyclase by the stimulatory Gprotein, phospholipase C by G_(q) and other cognate G proteins, andmodulation of diverse channels by G_(i) and other G proteins. In someembodiments, the human gastrointestinal cells or their membranes can beused to examine the effect of a compound on intermediate steps of signaltransduction, such as the generation of diacyl glycerol and IP₃ byphospholipase C and, in turn, calcium mobilization by IP₃. In someembodiments, the compound may act directly on, e.g., the G protein,affecting downstream events indirectly. In some embodiments, thecompound may directly affect the downstream effector. For a generalreview and methods of assaying taste signal transduction andgastrointestinal protein hormone signal transduction, see, e.g., Methodsin Enzymology, vols. 237 and 238 (1994) and volume 96 (1983); Bourne etal., Nature, 10, 117-27 (1991); Bourne et al., Nature, 348, 125-32(1990); Pitcher et al., Annu. Rev. Biochem., 67, 653-92 (1998); Brubakeret al., Receptors Channels, 8, 179-88 (2002); Kojima et al., Curr. Opin.Pharmacol., 2, 665-68 (2002); Bold et al., Arch Surg., 128, 1268-73(1993).

The effects of compounds on taste signaling polypeptides and/orgastrointestinal protein hormones, neurotransmitters or solublemediators can be examined by performing assays described herein andknown in the art. Any suitable physiological change that affects thesesignaling pathways can be used to assess the influence of a compound onthe cells of this invention.

The effects of compounds on signal transduction in any of the aboveassays may be detected or measured in a variety of ways. For example,one can detect or measure effects such as transmitter release, hormonerelease, transcriptional changes to both known and uncharacterizedgenetic markers (e.g., northern blots), changes in cell metabolism suchas cell growth or pH changes, ion flux, phosphorylation,dephosphorylation, and changes in intracellular second messengers suchas Ca²⁺, IP₃, DAG, PDE, cGMP or cAMP. Changes in second messenger levelscan be optionally measured using, e.g., fluorescent Ca²⁺ indicator dyesand fluorometric imaging.

In some embodiments the effects of a compound on G-protein-coupledreceptors can be measured by using cells that are loaded with ion- orvoltage-sensitive dyes, which report receptor activity. Assays thatexamine the activity of such proteins can also use known agonists andantagonists for other G-protein-coupled receptors as negative orpositive controls to assess the activity of a test compound. To identifymodulatory compounds, changes in the level of ions in the cytoplasm ormembrane voltage can be monitored using an ion-sensitive ormembrane-voltage fluorescent indicator, respectively. Among theion-sensitive indicators and voltage probes that may be employed arethose sold by Molecular Probes or Invitrogen. For G-protein-coupledreceptors, lax G-proteins such as Ga15 and Ga16 can be used in the assayof choice (Wilkie et al., 1991, PNAS 88, 10049-53). Such lax G-proteinsallow coupling of a wide range of receptors.

The effects of a compound can be measured by calculating changes incytoplasmic calcium ion levels. In some embodiments, levels of secondmessengers such as IP₃ can be measured to assess G-protein-coupledreceptor function (Berridge & Irvine, 1984, Nature, 312, 315-21). Cellsexpressing such G-protein-coupled receptors may exhibit increasedcytoplasmic calcium levels as a result of contribution from bothintracellular stores and via activation of ion channels, in which caseit may be desirable although not necessary to conduct such assays incalcium-free buffer, optionally supplemented with a chelating agent suchas EGTA, to distinguish fluorescence response resulting from calciumrelease from internal stores.

The effects of a compound can be measured by determining the activity ofproteins which, when activated, result in a change in the level ofintracellular cyclic nucleotides, e.g., cAMP or cGMP, by activating orinhibiting enzymes such as adenylyl cyclase. There are cyclicnucleotide-gated ion channels, e.g., rod photoreceptor cell channels andolfactory neuron channels that are permeable to cations upon activationby binding of cAMP or cGMP (see, e.g., Altenhofen et al., 1991, Proc.Natl. Acad. Sci. U.S.A., 88, 9868-72 and Dhallan et al., 1990, Nature,347, 184-87). In cases where activation of the protein results in adecrease in cyclic nucleotide levels, it may be preferable to expose thecells to agents that increase intracellular cyclic nucleotide levels,e.g., forskolin, prior to adding a compound to the cells in the assay.

The effects of a compound can be measured by calculating changes inintracellular cAMP or cGMP levels using immunoassays or bioassays(Simon, 1995, J. Biol. Chem., 270, 15175-80; Felley-Bosco et al., 1994,Am. J. Resp. Cell and Mol. Biol., 11, 159-64; and U.S. Pat. No.4,115,538), or by examining phosphatidyl inositol (PI) hydrolysisaccording to, e.g., U.S. Pat. No. 5,436,128.

Transcription levels can also be transcription calculated. The humancell or its membrane containing the protein of interest may be contactedwith a compound for a sufficient time to effect any interactions, andthen the level of gene expression is measured. The amount of time toeffect such interactions may be empirically determined, such as byrunning a time course and measuring the level of transcription as afunction of time. The amount of transcription may be measured by usingany method known to those of skill in the art to be suitable. Forexample, mRNA expression of the protein of interest may be detectedusing northern blots, or polypeptide products may be identified usingimmunoassays or bioassays. Alternatively, transcription-based assaysusing reporter gene(s) may be used as described in U.S. Pat. No.5,436,128. The reporter gene(s) can be, e.g., chloramphenicolacetyltransferase, firefly luciferase, bacterial luciferase,betagalactosidase and alkaline phosphatase. Furthermore, the protein ofinterest can act as an indirect reporter via attachment to a secondreporter such as green fluorescent protein (see, e.g., Mistili &Spector, 1997, Nature Biotechnology, 15, 961-64).

The amount of transcription is then compared to the amount oftranscription in the same cell in the absence of a compound.Alternatively, the amount of transcription may be compared with theamount of transcription in a substantially identical cell that lacks theprotein of interest. For example, a substantially identical cell may bederived from the same cells from which the recombinant cell was preparedbut which had not been modified by introduction of heterologous DNA. Anydifference in the amount of transcription indicates that a compound hasin some manner altered the activity of the protein of interest. In someembodiments, a compound is administered in combination with a knownagonist or antagonist of transcription, to determine whether a compoundcan alter the activity of the agonist or antagonist.

The compounds tested can be any small chemical compound, or a biologicalmaterial or entity, such as a protein, amino acid, sugar, nucleic acidor lipid. Alternatively, the compounds tested can be variants of tastesignaling proteins. Typically, compounds will be small chemicalmolecules and peptides. Essentially any chemical compound can be used asa potential chemosensory receptor ligand in the assays of the inventionalthough most often compounds dissolved in aqueous or organic solutionsare used. The assays can be used to screen large chemical libraries byautomating the assay steps (e.g., in microtiter formats on microtiterplates in robotic assays).

Regional Hormone Concentrations

Gut hormones secreted by enteroendocrine cells are released from theirbasolateral aspect into the mesenteric venous circulation. Therefore,these hormones traverse the portal vein area which drains all mesentericvenous efflux. Gut hormones, typically peptides, are alsoneurotransmitters and as such can stimulate afferent nerve endings thatemanate from the gut and the liver. It is well recognized that CCKcauses afferent vagal activation and that its physiologic effects aredue almost exclusively to this neural activation. Hormones such asGLP-1, oxyntomodulin, PYY and GIP, and their post DPP-IV degradationbreakdown products can have physiologic effects at the level gut nervesand can activate portal receptor/signaling pathways to cause activationof hepatic afferents. The action of GLP-1 to cause glucose-dependentinsulin secretion is thought to predominantly occur via neuralactivation as its degradation by DPP-IV upon release begins immediatelycausing its circulating half-life to be less than 2 minutes. Moreover,the portal:arterial gradient for GLP-1 is large (>2:1) thus making itsendocrine function in the beta cell excessively inefficient. Given itsportal to peripheral gradient and its action as a neurotransmitter toactivate gut afferent nerves, and its role to cause portal activation ofhepatic afferents it is plausible that GLP-1's physiologic andpharmacologic actions can be produced in the absence of largefluctuations (and even perhaps undetectable alterations) of circulatingperipheral (arterial or post hepatic venous) concentrations of GLP-1. Assuch GLP-1 is akin to norepinephrine which is a neurotransmitter butspills over into the circulation; like GLP-1, norepinephrine can beinfused peripherally to act as a hormone to reproduce many of itsphysiologic functions. Thus, in some embodiments, the compositions andmethods provided herein produce salutary effects on blood glucose andweight loss by enhancing portal concentrations of gut hormones whileminimally augmenting peripheral concentrations.

Combinations

The chemosensory receptor ligands can be administered alone or incombination with each other. In certain embodiments, nonmetabolizedchemosensory receptor ligands or combinations thereof are administeredwith one or more metabolized chemosensory receptor ligands, e.g.,metabolite(s). Dosages for each chemosensory receptor ligand (i.e.ligands which bind and/or modulate sweet, umami, bitter, fat, sour,and/or bile acid receptors) can be determined via methods disclosedherein and found in the examples. Maximal response doses and maximumtolerated doses can be determined via animal and human experimentalprotocols as described herein and found in the examples. Additionalrelative dosages, represented as a percent of maximal response or ofmaximum tolerated dose, are easily obtained via the protocols.

In an exemplary dose-response experiment, chemosensory receptor ligandscorresponding to five of the chemosensory receptors (e.g., sucralose,MSG, quinine, fatty acid emulsion, and chenodeoxycholic acid) andglucose are individually administered in an animal model (e.g. diabeticor obese rat model) to determine the optimum doses for each chemosensoryreceptor ligand. Chemosensory receptor ligands are administeredindividually at increasing amounts (mg/kg/min), where each subject isadministered a set mg/kg/min dose and the dose is maintained at this setlevel for a defined period. Blood samples are collected at frequentintervals (e.g., every 1, 2, or 5 minutes) throughout the period andassayed for hormone levels. Hormones assayed include CCK, GIP, GLP-1,Oxyntomodulin, Peptide YY, Insulin C-peptide, and GLP-2. 50% of maximalresponse dose and 50% of the maximum tolerated dose are determined foreach chemosensory receptor ligand.

In some embodiments, at least one chemosensory receptor ligand isadministered at a concentration that is 50% of the maximal responsedose. In other embodiments, at least one chemosensory receptor ligand isadministered at a concentration that is 50% of the maximum tolerateddose. Chemosensory receptor ligands can be administered as 5%, 10%, 20%,25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%,95%, or 100%, of the maximum response or maximum tolerated dose,inclusive of all integers therein.

Alternatively, the chemosensory receptor ligands described herein can beadministered by a set potency range or limit of the chemosensoryreceptor ligands to their respective receptors. For example, in theabove-referenced table of exemplary sweet receptor ligands of plantorigin, sweetness potency can be expressed as relative sweetness to anequivalent weight comparison basis to sucrose (=1.0). Thus, for examplein some embodiments, a composition comprising a sweet receptor ligandcan be administered at a dosage that is of at least about 100×, at leastabout 200×, at least about 300×, at least about 400×, at least about500×, at least about 600×, at least about 700×, at least about 800×, atleast about 900×, at least about 1000×, at least about 1500×, at leastabout 2000×, at least about 2500×, at least about 3000×, at least about4000×, at least about 5000×, at least 7500×, or at least 10000× theequivalent to the sweetness potency of sucrose per day. In otherembodiments, a composition comprising a sweet receptor ligand can beadministered at a dosage that is of about 100× to 10000×, about 500× to5000×, about 700× to about 4000× or about 1000× to about 3000× theequivalent to the sweetness potency of sucrose per day. Ligands forother chemosensory receptors such as bitterness, sour or salt ligandscan be dosed in similar manner in accordance to a known bitterness, souror salty potency reference. For example, the Labeled Magnitude Scaleallows measurement of a perceived intensity or potency of a bitter orsalty taste sensation. See, e.g., Green et al., 1996, Chemical Senses 2:323-334. This measured intensity can then be compared with a referencestandard such as NaCl salt or quinine. Dose administration can beexpressed in, for example, delivery of at least about 1000× sweetnesspotency of sucrose, of at least about 2× a bitterness potency ofquinine, and the like. Also, multiple ligands for a certain receptor canbe used to achieve a desired potency dose; e.g., two or more sweetligands can be used to achieve about 1000× sweetness potency of sucrose.

Alternatively, chemosensory receptor ligands described herein can beadministered by weight measurement. By way of example, sweet, umami, andbitter receptor ligands (e.g., sucralose, glucose, monosodium glutamate,quinine) can be administered in amounts ranging from about 0.01 to about100 mg/kg, inclusive of all integers therein. Fat receptor ligands(e.g., Intralipid®) can be administered as an emulsion/solution having arange of concentrations from about 0.5-about 20% solution delivered at0.5-10 ml/min. Similarly, bile acid receptor ligands (e.g.,Chenodeoxycholic acid, or CDC) can be administered as a solution havinga range of concentrations from about 1 to about 50 mMol at a delivery of1-10 ml/min. Metabolites, including non-limiting examples such asglucose and glutamates, can be administered in amounts ranging fromabout 0.1 to about 10 mg/kg, inclusive of all integers therein.

Another dose administration by weight can be on the basis of a weight ofa chemosensory receptor ligand to achieve a certain multiple of naturalligand such as sucrose (e.g., a dosage amount of at least as sweet as100 grams of sucrose). For example, in some embodiments, a compositioncomprising a sweet receptor ligand can be administered at a dosage thatis equivalent to a sweetness potency of at least 100 grams, at least 500grams, at least 750 grams, at least 1000 grams, at least 1250 grams, atleast 1500 grams, at least 1750 grams, at least 2000 grams, at least2500 grams, at least 3000 grams, at least 4000 grams, at least 5000grams, or at least 10000 grams of sucrose per day. In other embodiments,a composition comprising a sweet receptor ligand can be administered ata dosage that is equivalent to the sweetness potency of about 100 to10000 grams, about 500 to 5000 grams, about 750 to about 4000 grams orabout 1000 to about 3000 grams of sucrose per day. Ligands for otherchemosensory receptors such as bitterness, sour or salt ligands can bedosed in similar manner in accordance to a known bitter, sour or saltypotency reference. Dose administration can be expressed in, for example,delivery of a sweetness potency of at least about 1000 grams sucrose, abitterness potency of at least about 2 grams of quinine, and the like.Also, multiple ligands for a certain receptor can be used to achieve adesired potency dose; e.g., two or more sweet ligands can be used toachieve a sweetness potency equivalent to about 1000 grams of sucrose.

The combinations of chemosensory receptor ligands can be administered ina single composition or in multiple compositions. Multiple compositionsmay be administered simultaneously or at different times. Thecompositions may be administered in different delivery forms (i.e.,tablets, powders, capsules, gels, liquids, nutritional supplements,edible food preparations (e.g. medical foods, bars, gels, liquids, etc.)and in any combination of such forms.

In one non-limiting example, a tablet containing at least onechemosensory receptor ligand is administered simultaneously with anothertablet containing at least one chemosensory receptor ligand to providethe desired dosage. In a further example, the two tablets areadministered at different times. In another non-limiting example, atablet containing the desired combination of chemosensory receptorligand(s) is administered to provide the full dosage. Any combination ofdelivery forms, compositions, and delivery times are contemplatedherein.

The constituents of the compositions provided by the invention can bevaried both with respect to the individual constituents and relativeproportions of the constituents. In embodiments, the relative proportionof the constituents is optimized to produce the desired synergisticactivity from the drug combination. For example, in a compositioncomprising, or a method comprising administering, two constituents,e.g., two chemosensory receptor ligands, the constituents can be presentin ratios of or about, e.g., 1:1, 1:2, 1:3, 1:4, 1:5, 1:6, 1:7, 1:8,1:9, 1:10, 1:15, 1:20, 1:25, 1:30, 1:35, 1:40, 1:45, 1:50, 1:60, 1:70,1:80, 1:90, 1:100, 1:200, 1:300, 1:400, 1:500, 1:1000, etc. In acomposition comprising, or a method comprising administering, threeconstituents, for example, two nonmetabolized chemosensory receptorligands, and a metabolized chemosensory receptor ligand, theconstituents can be present in ratios of or about, e.g., 1:1:1, 2:1:1,2:2:1, 3:1:1, 3:3:1, 3:2:2, 3:3:2, 3:2:1, 4:1:1, 4:4:1, 4:2:2, 4:4:2,4:2:3, 4:3:3, 4:4:3, 4:2:1, 5:1:1, 5:5:1, 5:2:1, 5:3:1, 5:3:2, 5:3:4,5:5:2, 5:5:3, 5:5:4, 10:1:1, 10:10:1, etc.

In some embodiments, the invention provides combination treatmentschosen to mimic mixed meals. For example, one or more carbohydrates(sweet), and one or more proteins (umami) can be used in doublet andtriplet combinations. The combinations can be evaluated using methods ofthe invention and described herein. For example, a combination producesa desired hormonal release, glucose lowering and appetite suppressionfor the condition to be treated. In embodiments, additional ligands(e.g., tastants) that are specific for other chemosensory receptors canbe evaluated and included in the combinations as determined appropriateusing the methods of the invention. If one considers 5 tastants T1-T5(sweet, bitter, umami, fat and bile acids, respectively) there is 1combination of all 5 tastants (T1T2T3T4T5); there are 5 possiblecombinations of quadruplet tastant combinations (T1T2T3T4, T1T2T3T5,T1T2T4T5, T1T3T4T5, T2T3T4T5); 10 potential triplet (T1T2T3, T1T2T4,T1T2T5, T1T3T4, T1T3T5, T1T4T5, T2T3T4, T2T3T5, T2T4T5, T3T4T5) and 10potential doublet combinations (T1T2, T1T3, T1T4, T1T5, T2T3, T2T4,T2T5, T3T4, T3T5, T4T5).

In some embodiments, one or more nonmetabolized chemosensory receptorligand is administered alone or in combination with other nonmetabolizedchemosensory receptor ligands. In other embodiments, the one or morenonmetabolized chemosensory receptor ligand is provided in combinationwith one or more metabolized chemosensory receptor ligands. In someembodiments, a nonmetabolized chemosensory receptor ligand isadministered prior to a metabolized chemosensory receptor ligand. Inother embodiments, a nonmetabolized chemosensory receptor ligand isadministered after a metabolized chemosensory receptor ligand. In yetother embodiments, a nonmetabolized chemosensory receptor ligand isadministered at similar times to a metabolized chemosensory receptorligand. In certain instances, one or more metabolized chemosensoryreceptor ligands are derived from food. In certain aspects, a desiredcombination enhances and amplifies hormone signalling and secretionresulting from food ingestion. A non-limiting example of a combinationis a sucralose administration prior, after, or simultaneously with anadministration of sugar. In some aspects, a nonmetabolized chemosensoryreceptor ligand is delivered to the lower intestine and a metabolizedchemosensory receptor ligand is delivered to the upper intestine. Themetabolized chemosensory receptor ligand may or may not also be in thelower intestine. In other aspects, a nonmetabolized chemosensoryreceptor ligand is delivered to the same gastrointestinal segment as ametabolized chemosensory receptor ligand.

When more than one chemosensory receptor ligand is used in combinationwith at least one other ligand or compound, it is understood that thecombination treatment regimen encompasses treatment regimens in whichadministration of one compound is initiated prior to, during, or aftertreatment with a second or additional agent in the combination, andcontinues until any time during treatment with any other agent in thecombination or after termination of treatment with any other agent.Treatment regimens also include those in which the agents being used incombination are administered simultaneously or at different times and/orat decreasing or increasing intervals during the treatment period.Combination treatment includes periodic treatments that start and stopat various times to assist with the clinical management of the patient.

Indications

The methods of the embodiments provided herein are indicated fortreatment of conditions or disorders associated with a chemosensoryreceptor. Specifically, these conditions include those in whichmodulation of the metabolic hormones regulated by chemosensory receptorstimulation produces a desired effect. Among the conditions associatedwith a chemosensory receptor that are contemplated for treating usingthe compositions and methods of the embodiments herein are metabolicsyndrome, diabetes type I, diabetes type II, obesity, binge eating,undesired food cravings, food addiction, a desire to reduce food intakeor to lose weight or maintain weight loss, anorexia, glucoseintolerance, gestational diabetes mellitus (GDM), impaired fastingglycemia (IFG), dyslipidemia, post-prandial dyslipidemia,hyperlipidemia, hypertriglyceridemia, post hypertriglyceridemia, insulinresistance, bone loss disorders, osteopenia, osteoporosis, musclewasting disease, muscle degenerative disorders, polycystic ovarysyndrome (PCOS), non-alcoholic fatty liver disease (NAFL), non-alcoholicsteatohepatitis (NASH), depression, a mood disorder, immune disorders ofthe gut (e.g., celiac disease), bowel irregularity, irritable bowelsyndrome (MS), or inflammatory bowel disease (IBD), including, e.g.,ulcerative colitis, Crohn's disease, and short bowel syndrome. Forexample, disorders such as frailty, anorexia, cachexia, loss of leanbody mass, food associated or food-induced nausea and vomiting, foodallergies, food associated aversive reactions may be treated withchemosensory receptor antagonists.

In some embodiments, the compositions and methods provided herein areindicated for treatment, prevention and or maintenance of a metabolicdisorder, disease or defect. Metabolic disorders, diseases or defectscan include disorders, diseases or defects in energy homeostasis anddisorders, diseases or defects in fuel homeostasis.

In certain embodiments, the compositions and methods provided herein areindicated for treatment, prevention and or maintenance of disorders,diseases and defects associated with energy homeostasis. Energyhomeostasis generally relates to the signally pathways, molecules andhormones associated with food intake and energy expenditure. Disorders,diseases and defects associated with energy homeostasis include but arenot limited to diabetes type I, diabetes type II, prediabetes, impairedfasting glycemia (IFG), and gestational diabetes mellitus (GDM). In someinstances the compositions and methods provided herein are indicated fortreatment, prevention and or maintenance of diabetes type I or type II.

In certain embodiments, the compositions and methods provided herein areindicated for treatment, prevention and or maintenance of disorders,diseases and defects associated with fuel homeostasis. Disorders,diseases and defects associated with fuel homeostasis include but is notlimited to non-alcoholic fatty liver disease (NAFL), non-alcoholicsteatohepatitis (NASH), hyperlipidemia, post hypertriglyceridemia,hypertriglyceridemia, insulin resistance and polycystic ovary syndrome(PCOS).

The embodiments also provide compositions and methods useful fortreating conditions in which an increase in insulin secretion or controlof glucose levels resulting from modulation of enteroendocrine cellhormones (e.g., GLP-1 or GIP) would be beneficial. These conditionsinclude, but are not limited to, metabolic syndrome, diabetes type 1,diabetes type II, gestational diabetes, glucose intolerance, and relatedconditions including those in which patients suffer from glucoseintolerance.

The embodiments also provide compositions and methods for modulatinggrowth (proliferation), and/or generation (neogenesis), and/orprevention of cell death (apoptosis) of insulin producing and secretingcells (Beta cells) through the release of neural and hormonal signalsemanating from the gut in response to luminal chemosensory stimulation.Gut hormones such as GLP-1, PYY, GLP-2 and gastrin have all beenimplicated in the process of beta cell preservation or beta cell massexpansion. In one aspect, chemosensory stimulation provides a hormonalsignal coupled to a neural signal. The hormonal signal can occur before,after or at similar timeframes as the neural signal.

The embodiments also provide compositions and methods for treatingconditions in which appetite suppression resulting from modulation of,e.g., PYY, oxyntomodulin, and/or CCK, would be beneficial. Theseconditions include, but are not limited to, obesity, binge eating,undesired food cravings, a desire to reduce food intake or to loseweight or maintain weight loss, and related conditions.

Further provided are compositions and methods for treating conditions inwhich proliferation of gut cells resulting from modulation of, e.g.,GLP-2, would be beneficial, such as, short bowel syndrome, Crohn'sdisease, inflammatory bowel disease, ulcerative colitis, and otherconditions resulting in bowel damage, including osteoporosis.

Methods of Treatment

Disorders of Glucose Metabolism

The embodiments described herein provide compositions and methods fortreating and preventing disorders of glucose metabolism and theirassociated conditions.

For example, provided herein are methods for treating mammalian subjectswith diabetes, including primary essential diabetes such as Type IDiabetes or Type II Diabetes (NIDDM) and secondary nonessentialdiabetes, comprising administering to the subject at least onechemosensory receptor ligand as described herein. In accordance with themethod of this invention a symptom of diabetes or the chance ofdeveloping a symptom of diabetes, such as atherosclerosis, obesity,hypertension, hyperlipidemia, fatty liver disease, nephropathy,neuropathy, retinopathy, foot ulceration and cataracts, each suchsymptom being associated with diabetes, can be reduced.

The methods and compositions provided by the invention are useful forpreventing or ameliorating diseases and symptoms associated withhyperglycemia and insulin resistance or low insulin levels. While acluster of signs and symptoms associated may coexist in an individualpatient, it many cases only one symptom may dominate, due to individualdifferences in vulnerability of the many physiological systems affectedby insulin resistance. Nonetheless, since hyperglycemia and insulinresistance are major contributors to many disease conditions, agentsthat address these cellular and molecular defects are useful forprevention or amelioration of virtually any symptom in any organ systemthat may be due to, or exacerbated by hyperglycemia and insulinresistance.

Metabolic syndrome is a cluster of metabolic abnormalities includingabdominal obesity, insulin resistance, glucose intolerance, diabetes,hypertension and dyslipidemia. These abnormalities are known to beassociated with an increased risk of vascular events.

In addition to the metabolic disorders related to insulin resistanceindicated above, disease symptoms secondary to hyperglycemia also occurin patients with NIDDM. These include nephropathy, peripheralneuropathy, retinopathy, microvascular disease, ulceration of theextremities, and consequences of nonenzymatic glycosylation of proteins,e.g. damage to collagen and other connective tissues. Attenuation ofhyperglycemia reduces the rate of onset and severity of theseconsequences of diabetes. Because compositions and methods of theinvention help to reduce hyperglycemia in diabetes, they are useful forprevention and amelioration of complications of chronic hyperglycemia.

Elevated triglyceride and free fatty acid levels in blood affect asubstantial fraction of the population and are an important risk factorfor atherosclerosis and myocardial infarction. Provided herein arecompositions and methods useful for reducing circulating triglyceridesand free fatty acids in hyperlipidemic patients. Hyperlipidemic patientsoften also have elevated blood cholesterol levels, which also increasethe risk of cardiovascular disease. Cholesterol-lowering drugs such asHMG-CoA reductase inhibitors (“statins”) can be administered tohyperlipidemic patients in addition to chemosensory receptor ligandcompositions of the invention, optionally incorporated into the samepharmaceutical composition.

A substantial fraction of the population is affected by fatty liverdisease, also known as nonalcoholic steatohepatitis (NASH); NASH isoften associated with obesity and diabetes. Hepatic steatosis, thepresence of droplets of triglycerides with hepatocytes, predisposes theliver to chronic inflammation (detected in biopsy samples asinfiltration of inflammatory leukocytes), which can lead to fibrosis andcirrhosis. Fatty liver disease is generally detected by observation ofelevated serum levels of liver-specific enzymes such as thetransaminases ALT and AST, which serve as indices of hepatocyte injury,as well as by presentation of symptoms which include fatigue and pain inthe region of the liver, though definitive diagnosis often requires abiopsy. The anticipated benefit is a reduction in liver inflammation andfat content, resulting in attenuation, halting, or reversal of theprogression of NASH toward fibrosis and cirrhosis.

Hypoinsulinemia is a condition wherein lower than normal amounts ofinsulin circulate throughout the body and wherein obesity is generallynot involved. This condition includes Type I diabetes.

Type 2 Diabetes or abnormal glucose metabolism may be caused by avariety of factors and may manifest heterogeneous symptoms. Previously,Type 2 Diabetes was regarded as a relatively distinct disease entity,but current understanding has revealed that Type 2 Diabetes (and itsassociated hyperglycemia or dysglycemia) is often a manifestation of amuch broader underlying disorder, which includes the metabolic syndromeas noted above. This syndrome is sometimes referred to as Syndrome X,and is a cluster of cardiovascular disease risk factors that, inaddition to glucose intolerance, includes hyperinsulinaemia,dyslipidaemia, hypertension, visceral obesity, hypercoagulability, andmicroalbuminuria.

Also provided herein are compositions and methods for treating obesity,comprising administering to the subject at least one chemosensoryreceptor ligand as described herein in an amount effective to treat thecondition. The agent can be administered orally, and alternatively,other routes of administration that can be used in accordance with thisinvention include rectally, and parenterally, by injection (e.g., byintraluminal intestinal injection).

Both human and non-human mammalian subjects can be treated in accordancewith the methods of this invention. In embodiments, the presentinvention provides compositions and methods for preventing or treatingdiabetes in a wide range of subject mammals, in particular, a humanpatient that has, has had, is suspected of having, or who ispre-disposed to developing diabetes. Diabetes mellitus is selected fromthe group consisting of insulin-dependent diabetes mellitus (IDDM ortype I diabetes) and non-insulin-dependent diabetes mellitus (NIDDM, ortype II diabetes). Examples of disorders related to diabetes mellitushave been described and include, but are not limited to, impairedglucose tolerance (IGT); maturity-onset diabetes of youth (MODY);leprechaunism (insulin receptor mutation), tropical diabetes, diabetessecondary to a pancreatic disease or surgery; diabetes associated with agenetic syndrome (e.g., Prader-Willi syndrome); pancreatitis; diabetessecondary to endocrinopathies; adipositas; and metabolic syndrome(syndrome X).

Diabetic subjects appropriate for treating using the compositions andmethods provided by the invention can be easily recognized by thephysician, and are characterized by, e.g., fasting hyperglycemia,impaired glucose tolerance, glycosylated hemoglobin, and, in someinstances, ketoacidosis associated with trauma or illness. Hyperglycemiaor high blood sugar is a condition in which an excessive amount ofglucose circulates in the blood plasma. This is generally a bloodglucose level of 10+ mmol/L, but symptoms and effects may not start tobecome noticeable until later numbers such as 15-20+ mmol/L. NIDDMpatients have an abnormally high blood glucose concentration whenfasting and delayed cellular uptake of glucose following meals or aftera diagnostic test known as the glucose tolerance test. NIDDM isdiagnosed based on recognized criteria (American Diabetes Association,Physician's Guide to Insulin-Dependent (Type I) Diabetes, 1988; AmericanDiabetes Association, Physician's Guide to Non-Insulin-Dependent (TypeII) Diabetes, 1988). The optimal dose of a particular chemosensoryreceptor ligand composition for a particular subject can be determinedin the clinical setting by a skilled clinician.

Chronic Kidney Disease, Diabetic Nephropathy, Macular Degeneration andDiabetes-Associated Conditions

The compositions and methods provided herein can be used to prevent ortreat kidney diseases. Diabetes is the most common cause of chronickidney disease and kidney failure, accounting for nearly 44 percent ofnew cases. Even when diabetes is controlled, the disease can lead tochronic kidney disease and kidney failure. Most people with diabetes donot develop chronic kidney disease that is severe enough to progress tokidney failure. Nearly 24 million people in the United States havediabetes, and nearly 180,000 people are living with kidney failure as aresult of diabetes. High blood pressure, or hypertension, is a majorfactor in the development of kidney problems in people with diabetes.

Accumulation of the glomerular mesangial extracellular matrix (ECM)leading to glomerulosclerosis is a common finding in diabeticnephropathy and other chronic kidney diseases. Several lines of evidenceindicate that ECM accumulation in such chronic renal diseases resultsfrom both increased synthesis and decreased degradation of ECMcomponents and it is widely accepted that ECM degradation in glomeruliand glomerular cells is mediated by a plasminogenactivator-plasmin-matrix metalloproteinase-2 (MMP)-2 cascade. Inaddition, a variety of studies have reported decreased plasminogenactivator (PA) activity, decreased plasmin activity, or increased levelsof PA inhibitor 1 (PAI-1; the major PA inhibitor), in glomeruli obtainedfrom animals with experimentally induced glomerular injuries known toresult in mesangial matrix accumulation (Baricos, et al., “ExtracellularMatrix Degradation by Cultured Mesangial Cells: Mediators andModulators” (2003) Exp. Biol. Med. 228:1018-1022).

Macular degeneration (AMD) is the loss of photoreceptors in the portionof the central retina, termed the macula, responsible for high-acuityvision. Degeneration of the macula is associated with abnormaldeposition of extracellular matrix components and other debris in themembrane between the retinal pigment epithelium and the vascularchoroid. This debris-like material is termed drusen. Drusen is observedwith a funduscopic eye examination. Normal eyes may have maculas free ofdrusen, yet drusen may be abundant in the retinal periphery. Thepresence of soft drusen in the macula, in the absence of any loss ofmacular vision, is considered an early stage of AMD.

Choroidal neovascularization (CNV) commonly occurs in maculardegeneration in addition to other ocular disorders and is associatedwith proliferation of choroidal endothelial cells, overproduction ofextracellular matrix, and formation of a fibrovascular subretinalmembrane. Retinal pigment epithelium cell proliferation and productionof angiogenic factors appears to effect choroidal neovascularization.

Diabetic retinopathy (DR) is an ocular disorder that develops indiabetes due to thickening of capillary basement membranes and lack ofcontact between pericytes and endothelial cells of the capillaries. Lossof pericytes increases leakage of the capillaries and leads to breakdownof the blood-retina barrier.

Proliferative vitreoretinopathy is associated with cellularproliferation of cellular and fibrotic membranes within the vitreousmembranes and on the surfaces of the retina. Retinal pigment epitheliumcell proliferation and migration is common with this ocular disorder.The membranes associated with proliferative vitreoretinopathy containextracellular matrix components such as collagen types I, II, and IV andfibronectin, and become progressively fibrotic.

Compositions of the embodiments described herein can be, as needed,administered in combination with one or more standard therapeutictreatments known in the art. For example, for treatment of diabeticnephropathy, compounds of the present invention can be administered incombination with, for example, ACE inhibitors, angiotensin II receptorblockers (ARBS) or any other conventional therapy such as, for example,glucose management.

Obesity and Eating Disorders

Further provided herein are compositions and methods that can be used toprevent or treat obesity. Central obesity, characterized by its highwaist to hip ratio, is an important risk for metabolic syndrome.Metabolic syndrome, as described above, is a combination of medicaldisorders which often includes diabetes mellitus type 2, high bloodpressure, high blood cholesterol, and triglyceride levels (Grundy S M(2004), J. Clin. Endocrinol. Metab. 89(6): 2595-600). Obesity and othereating disorders are described in, e.g., U.S. Pat. App. Pub. No.2009/0062193, “Compositions and Methods for the Control, Prevention andTreatment of Obesity and Eating Disorders.”

“Obesity” is generally defined as a state wherein the body mass index isover 30, but any subject, including those with a body mass index of lessthan 30, who needs or wishes to reduce body weight or prevent bodyweight gain can be considered to be obese or overweight. For example,subjects with a BMI of less than 30 and 25 and above or below 25 arealso included among the subjects of the invention. Morbid obesitytypically refers to a state wherein the BMI is 40 or greater. Inembodiments, the subject may be suffering from or be susceptible to acondition associated with eating such as binge eating or food cravings.

A “subject’ may include any mammal, including humans. A “subject” mayalso include other mammals kept as pets or livestock (e.g., dogs, cats,horses, cows, sheep, pigs, goats). Subjects who may benefit from themethods provided herein may be overweight or obese; however, they mayalso be lean. Subjects who may benefit from the methods provided hereinmay be desirous of losing weight or may have an eating disorder, such asbinge eating, or an eating condition, such as food cravings. Subjectswho may benefit from the methods provided herein may be desirous ofmodifying food preferences. They may have a metabolic disorder orcondition in addition to these conditions. Exemplary metabolic disordersinclude diabetes, metabolic syndrome, insulin-resistance, anddyslipidemia. Subjects can be of any age. Accordingly, these disorderscan be found in young adults and adults (e.g., those aged 65 or under)as well as infants, children, adolescents, and the elderly (e.g., thoseover the age of 65).

By “metabolic rate” is meant the amount of energy liberated/expended perunit of time. Metabolism per unit time can be estimated by foodconsumption, energy released as heat, or oxygen used in metabolicprocesses. It is generally desirable to have a higher metabolic ratewhen one wants to lose weight. For example, a person with a highmetabolic rate may be able to expend more energy (and burn morecalories) to perform an activity than a person with a low metabolic ratefor that activity.

As used herein, “lean mass” or “lean body mass” refers to muscle andbone. Lean body mass does not necessarily indicate fat free mass. Leanbody mass contains a small percentage of fat (roughly 3%) within thecentral nervous system (brain and spinal cord), marrow of bones, andinternal organs. Lean body mass is measured in terms of density. Methodsof measuring fat mass and lean mass include, but are not limited to,underwater weighing, air displacement plethysmograph, x-ray, dual-energyx-ray absorptiometry (DEXA) scans, MRIs and CT scans. In one embodiment,fat mass and lean mass is measured using underwater weighing.

By “fat distribution” is meant the location of fat deposits in the body.Such locations of fat deposition include subcutaneous, visceral andectopic fat depots.

By “subcutaneous fat” is meant the deposit of lipids just below theskin's surface. The amount of subcutaneous fat in a subject can bemeasured using any method available for the measurement of subcutaneousfat. Methods of measuring subcutaneous fat are known in the art, forexample, those described in U.S. Pat. No. 6,530,886.

By “visceral fat” is meant the deposit of fat as intra-abdominal adiposetissue. Visceral fat surrounds vital organs and can be metabolized bythe liver to produce blood cholesterol. Visceral fat has been associatedwith increased risks of conditions such as polycystic ovary syndrome,metabolic syndrome and cardiovascular diseases.

By “ectopic fat storage” is meant lipid deposits within and aroundtissues and organs that constitute the lean body mass (e.g., skeletalmuscle, heart, liver, pancreas, kidneys, blood vessels). Generally,ectopic fat storage is an accumulation of lipids outside classicaladipose tissue depots in the body.

Fat mass can be expressed as a percentage of the total body mass. Insome aspects, the fat mass is reduced by at least 1%, at least 5%, atleast 10%, at least 15%, at least 20%, or at least 25% over the courseof a treatment. In one aspect, the subject's lean mass is not decreasedover the course of a treatment.

In another aspect, the subject's lean mass is maintained or increasedover the course of a treatment. In another aspect, the subject is on areduced calorie diet or restricted diet. By “reduced calorie diet” ismeant that the subject is ingesting fewer calories per day than comparedto the same subject's normal diet. In one instance, the subject isconsuming at least 50 fewer calories per day. In other instances, thesubject is consuming at least 100, 150 200, 250, 300, 400, 500, 600,700, 800, 900, 1000 fewer calories per day. In some embodiments, themethod involves the metabolism of visceral fat or ectopic fat or both ata rate of at least about 5%, 10%, 15%, 20%, 25%, 30%, 40%, or 50%,greater than for subcutaneous fat. In one aspect, the methods result ina favorable fat distribution. In one embodiment, favorable fatdistribution is an increased ratio of subcutaneous fat to visceral fat,ectopic fat, or both. In one aspect, the method involves an increase inlean body mass, for example, as a result of an increase in muscle cellmass. In one embodiment, the amount of subcutaneous fat is reduced in asubject by at least about 5%. In other embodiments, the amount ofsubcutaneous fat is reduced by at least about 10%, 15%, 20%, 25%, 30%40%, or 50% compared to the subject prior to administration of achemosensory receptor ligand composition.

The methods described herein can be used to reduce the amount ofvisceral fat in a subject. In one instance, the visceral fat is reducedin a subject by at least about 5%. In other instances, the visceral fatis reduced in a subject by at least about 10%, 15%, 20%, 25%, 30% 40%,or 50% compared to the subject prior to administration of a chemosensoryreceptor ligand composition. Visceral fat can be measured through anymeans available to determine the amount of visceral fat in a subject.Such methods include, for example, abdominal tomography by means of CTscanning and MRI. Other methods for determining visceral fat aredescribed, for example, in U.S. Pat. Nos. 6,864,415, 6,850,797, and6,487,445.

In one embodiment, a method for preventing the accumulation of ectopicfat or reducing the amount of ectopic fat in a subject is provided,wherein the method comprises administering, to a subject in needthereof, a chemosensory receptor ligand composition effective to preventaccumulation of ectopic fat or to reduce the amount of ectopic fat inthe subject. It is understood that a treatment can be a series ofindividual doses, or a treatment regimen, provided to the subject over aperiod of time. In one instance, the amount of ectopic fat is reduced ina subject by at least about 5% compared to the untreated subject. Inother instances, the amount of ectopic fat is reduced by at least about10%, 15%, 20%, 25%, 30% 40%, or 50%. Alternatively, the amount ofectopic fat is proportionally reduced 5%, 10%, 15%, 20%, 25%, 30%, 40%,50%, 60%, 70%, 80%, 90%, or 100% in comparison to subcutaneous fat in asubject. Ectopic fat can be measured in a subject using any methodavailable for measuring ectopic fat.

In another embodiment, methods for altering anthropometric parameters,e.g., waist circumference, hip circumference, and waist-to-hip ratio areprovided. Waist circumference is a measure of abdominal obesity. In oneembodiment, methods for reducing waist circumference of a subject areprovided, wherein the method comprises administering, to a subject inneed thereof, a chemosensory receptor ligand composition in an amounteffective to reduce the waist circumference of the subject. In oneembodiment, the waist circumference of the subject is reduced by atleast about 1%. In other embodiments, the waist circumference of thesubject is reduced by at least about 2%, 3%, 4%, 5%, 6%, 7%, 8%. 9% or10% compared to the subject prior to administration of a chemosensoryligand receptor ligand composition provided herein. In one embodiment,the waist circumference of the subject is reduced by at least about 1cm. In other embodiments, the waist circumference of the subject isreduced by at least about 2 cm, 3 cm, 4 cm, 5 cm, or 6 cm compared tothe subject prior to administration of a chemosensory receptor ligandcomposition.

In another embodiment, methods for reducing hip circumference of asubject are provided, wherein the method comprises administering, to asubject in need thereof, a chemosensory receptor ligand compositionprovided herein in an amount effective to reduce the hip circumferenceof the subject. In one embodiment, the hip circumference of the subjectis reduced by at least about 1%. In other embodiments, the waistcircumference of the subject is reduced by at least about 2%, 3%, 4%,5%, or 6% compared to the subject prior to administration of achemosensory receptor ligand composition. In one embodiment, the waistcircumference of the subject is reduced by at least about 1 cm. In otherembodiments, the waist circumference of the subject is reduced by atleast about 2 cm, 3 cm, 4 cm, 5 cm, or 6 cm compared to the subjectprior to administration of a chemosensory receptor ligand composition.

Also provided are methods to reduce weight in a morbidly obese subjectby first reducing the subject's weight to a level below that of beingmorbidly obese, then administering an effective amount of a chemosensoryreceptor ligand composition to further reduce the subject's weight.Methods for reducing a subject's weight to being below that of morbidobesity include reducing caloric intake, increasing physical activity,drug therapy, bariatric surgery, such as gastric bypass surgery, or anycombinations of the preceding methods. In one aspect, administering thetreatment results in reduced caloric intake, which further reduces theweight of the subject. In another embodiment, methods are provided forreducing the body mass index (BMI) in a subject having a BMI of 40 orless by administering a chemosensory receptor ligand composition in anamount and regimen effective to further reduce the subject's weight.

In embodiments, methods for reducing the risk of developing metabolicdisorders are provided, where the method comprises administering to thesubject a chemosensory receptor ligand composition in an amounteffective to reduce the weight or control the blood glucose of asubject.

In another embodiment, methods for controlling or modifying eatingbehaviors are provided, wherein the methods comprise administering, to asubject in need thereof, a chemosensory receptor ligand compositioneffective to control or modify an eating behavior by the subject. In oneembodiment, methods for controlling binge eating are provided, where themethods comprise administering, to a subject in need thereof, achemosensory receptor ligand composition in an amount effect to controlor curb binge eating by the subject. In one embodiment, a chemosensoryreceptor ligand composition is administered at times of the day when thesubject is most likely to binge eat. In one aspect, binge eating ischaracterized by 1) eating, in a discrete period of time (e.g., withinany 2-hour period), an amount of food that is definitely larger thanmost people would eat during a similar period of time and under similarcircumstances and 2) a sense of lack of control over eating during theepisode (e.g., a feeling that one cannot stop eating or control what orhow much one is eating). The reduction of binge eating includes areduction in the frequency of binge eating episodes, the duration ofbinge eating episodes, the total amount consumed during a binge eatingepisode, difficulty in resisting the onset of a binge eating episode,and any combination thereof, as compared to as compared to suchfrequency, duration, amount and resistance in the absence of thechemosensory receptor ligand composition. For example, in oneembodiment, a method may comprise a reduction in the frequency of bingeeating episodes. In another embodiment, a method may comprise areduction in the duration of binge eating episodes. In yet anotherembodiment, a method may comprise a reduction in the total amountconsumed during a binge-eating episode. In yet another embodiment, amethod may comprise a reduction in difficulty resisting the onset of abinge-eating episode.

Some of the signs of binge eating include eating large amounts of foodwhen not physically hungry, rapid eating, hiding of food because theperson feels embarrassed about how much he or she is eating, eatinguntil uncomfortably full, or any combination thereof. Many binge eatersare emotional eaters, i.e. their binge eating is triggered by theiremotional state (e.g., some binge eaters eat when they are sad, some eatwhen they are happy, and some eat when they are under stress). A largenumber of binge eaters suffer from anxiety disorders, such asobsessive-compulsive disorder; impulse control problems; or personalitydisorders, such as borderline personality disorder or depression. In oneembodiment, the binge eating is in response to stressed conditions.Other binge eaters are substance abusers, such as drug abusers oralcohol abusers. Not everyone who has a binge eating disorder isoverweight, such as those binge eaters diagnosed with bulimia.

Subjects who binge eat often do so at particular times of the day, andthus treatment should be adjusted according to when the subject is mostlikely to binge eat. For example, if the subject binge eats mostly after7 p.m. at night, the subject should be administered a chemosensoryreceptor ligand composition at or shortly before 7 p.m. In oneembodiment, the subject is administered a chemosensory receptor ligandcomposition at the time they are susceptible to binge eating. In otherembodiments, the subject is administered a chemosensory receptor ligandcomposition at least about 5 minutes, at least about 15 minutes, atleast about 30 minutes, at least about 45 minutes, at least about 1hour, at least about 1 hour and 30 minutes, or at least about 2 hoursbefore they are susceptible to binge eating. An effective amount of achemosensory receptor ligand composition in this embodiment is an amounteffective to curb or control the subject's desire to binge eat.Therefore, the effective amount of a chemosensory receptor ligandcomposition will change dependent upon the subject and the level oftheir desire to binge eat. Furthermore, if a subject's desire to bingeeat is less at one point in the day than at another, the dosage can beadjusted accordingly to provide a lower dose at the times of the day thesubject has a lower desire to binge eat, and to provide a higher dose atthe times of the day the subject has a higher desire to binge eat. Inone embodiment, the subject is administered a peak dosage of achemosensory receptor ligand composition at the time they have a highdesire to binge eat. In other embodiments, the subject is administered apeak dosage of a chemosensory receptor ligand composition at least about5 minutes, at least about 15 minutes, at least about 30 minutes, atleast about 45 minutes, at least about 1 hour, at least about 1 hour and30 minutes, or at least about 2 hours before they have a high desire tobinge eat.

In another embodiment, methods for modifying food preferences in asubject are provided, wherein methods comprise administering, to asubject in need thereof, a chemosensory ligand receptor composition inan amount effective to modify food preferences in the subject. Thechemosensory receptor targeted by a composition can influence thesubject's desire to eat the corresponding food. For example, acomposition comprising ligands for the sweet receptor can reduce thesubject's desire for sweet foods. Therefore, in embodiments, thesubject's food preferences that are influenced by the treatment caninclude preferences for sweet foods, savory foods, high fat foods, saltyfoods, sour foods, and any combination thereof.

The modifications in food preferences may include a decrease in apreference for such foods, a decrease in the amount of intake of suchfoods, an enhancement of a preference of one food type over another foodtype, changes in frequency of cravings for such foods, duration ofcravings for such foods, intensity of cravings for such foods,difficulty in resisting cravings for such foods, frequency of eating inresponse to cravings for such foods, and any combination thereof, ascompared to such frequency, duration, intensity, or resistance in theabsence of treatment. In yet another embodiment, a method may comprisereducing a subject's preference for sweet foods, savory foods, high fatfoods, salty foods, sour foods, and any combination thereof.

In one embodiment, a method may comprise reducing a subject's frequencyof cravings for sweet foods, savory foods, high fat foods, salty foods,sour foods, and any combination thereof. In another embodiment, a methodmay comprise reducing a subject's duration of cravings for sweet foodssavory foods, high fat foods, salty foods, sour foods, and anycombination thereof, etc. In yet another embodiment, a method maycomprise reducing a subject's intensity of cravings for sweet foods,savory foods, high fat foods, salty foods, sour foods, and anycombination thereof. In yet another embodiment, a method may comprisereducing a subject's difficulty in resisting cravings for sweet foods,savory foods, high fat foods, salty foods, sour foods, and anycombination thereof. In yet another embodiment, a method may comprisereducing a subject's frequency of eating in response to cravings forsweet foods, savory foods, high fat foods, salty foods, sour foods, andany combination thereof. In yet another embodiment, a method maycomprise reducing a subject's intake of sweet foods, savory foods, highfat foods, salty foods, sour foods, and any combination thereof.

Treatment of Bowel Damage

The compositions and methods provided herein can be used for thetreatment of short bowel syndrome and compromised intestinal function(e.g., small bowel resection, colitis, enteritis, inflammatory bowelsyndrome, ischemic bowel, and chemotherapeutic injury to the intestine).Short bowel syndrome refers to the collection of symptoms caused byintestinal resection. Its symptoms include intractable diarrhea,dehydration, malabsorption of macronutrients, weight loss, malabsorptionof vitamins and trace elements and malnutrition. GLP-2 is known to slowgastric emptying, increase intestinal transit time and inhibit shamfeeding-induced gastric acid secretion. Patients with jejunostomy oftenhave impaired meal-stimulated GLP-2 responses, and thus impairedabsorption. Administration of GLP-2 in patients with jejunostomy hasbeen shown to improve intestinal absorption of energy and intestinal wetweight absorption as well as prolong gastric emptying of solids andliquids. See Jeppesen, P. B., 2003, “Clinical significance of GLP-2 inshort-bowel syndrome,” Journal of Nutrition 133 (11): 3721-4. GLP-2 isalso reported to stimulate intestinal growth in addition to inhibitinggastric secretion and gastric motility. Burrin et al., 2001,“Glucagon-like peptide 2: a nutrient-responsive gut growth factor,”Journal of Nutrition 131 (3): 709. Modulation of GLP-2 secretion throughthe administration of the compositions described herein can provide forthe treatment of short bowel syndrome and compromised intestinalfunction, including but not limited to, small bowel resection, colitis,enteritis, inflammatory bowel syndrome, ischemic bowel, andchemotherapeutic injury to the intestine.

Delivery to Specific Intestinal Locations

The density of L-cells increases along the length of the intestine withthe lowest density at the level of the duodenum and greatest in therectum. There is an approximately 80-fold increase in L-cell densityfrom the duodenum to rectum as assessed by peptide YY content. SeeAdrian et al., Gastroenterology 1985; 89:1070-77. Given that nutrientsor bile salts would not be expected to reach the colon much less therectum, the mechanism of these L-cells in the regulation of metabolismis not completely clear. While speculative, it is possible that productsproduced by the colonic flora could inform the gut of the microbial massand composition via L-cell sensors and in turn this information could berelayed to the CNS via hormonal and neural signals emanating from thecolonic and rectal area which is innervated quite differently than thesmall intestine. Regardless of the role of neuroendocrine cells in thecolon and rectum, the basis of this invention is to stimulate thesecells wherever they may be (for example, different individuals, andpatients with diabetes, might be expected to have differentdistributions and numbers of these cells) via the presentation of one ormore stimuli of taste and/or nutrient receptors and other stimulants forthe purpose of treating metabolic disorders.

The upper intestine has different EECs than the lower intestine. Forexample, CCK and GIP are released from the upper and not typically fromthe lower intestine, corresponding to I- and K-cells predominantly beinglocated in the upper gut. Conversely, L-cells are located predominantlyin the lower intestine. Therefore, hormonal release patterns are notonly chemosensory receptor ligand- and combination-specific but alsosite-specific in the intestine.

In embodiments, it is contemplated that sensing and/or metabolism ofnutrients in the upper intestine amplifies certain responses from thelower intestine. Moreover, L-cells located in the upper intestine canbehave differently than those in the lower region providing anotherlevel control for targeting chemosensory receptor ligands. For example,in embodiments, certain chemosensory receptor ligand combinationsdelivered to the upper intestine may be more favorable to a hormonalrelease pattern for the treatment of one disorder, e.g., diabetes,whereas that same combination delivered to the lower intestine may bemore appropriate for a different disorder, e.g., obesity. It is alsocontemplated that the same combination can produce a more favorablehormonal profile when presented to both the upper and lower intestine.

Thus, the embodiments described herein provide a treatment methodcomprising a combination of chemosensory receptor ligands that isengineered to deliver certain of the chemosensory receptor ligands toone or more locations of the intestine, for example, to optimizehormonal patterns achieved.

In some of the embodiments provided herein, the chemosensory receptorligands are delivered to one or more regions of the intestine. In someof the embodiments provided herein, the chemosensory receptor ligandsare delivered to one or more regions downstream or distal of thestomach. In certain embodiments, the chemosensory receptor ligands aredelivered to one or more regions of the upper intestine. In otherembodiments, the chemosensory receptor ligands are delivered to theduodenum, jejunum, ileum, or a combination thereof. In certainembodiments, the chemosensory receptor ligands are delivered to one ormore regions of the lower intestine. In other embodiments, thechemosensory receptor ligands are delivered to the caecum, colon,rectum, or a combination thereof. In yet other embodiments, thechemosensory receptor ligands are delivered downstream or distal of theduodenum. In additional embodiments, the chemosensory receptor ligandsare delivered downstream or distal of the jejunum.

In yet other embodiments, chemosensory receptor ligands are delivered toone or more regions of the upper intestine and one or more regions ofthe lower intestine. For example, chemosensory receptor ligands can bedelivered to the duodenum and the colon. In another non-limitingexample, chemosensory receptor ligands can be delivered to the duodenum,jujenum, ileum and colon. In further embodiments, chemosensory receptorligands are delivered to both the stomach and one or more regions of theintestine. For example, an oral formulation can release somechemosensory receptor ligands in the stomach and later into theintestine. More embodiments are described under Formulations.

Administration of chemosensory receptor ligands to certain regions orlocations of the intestine is achieved by any known method. In certainembodiments, enteral administration of chemosensory receptor ligands isperformed, e.g., in rodents or man. Intubation/cannulation is performedin lightly anaesthetized patients with silastic tubing. Tubing is placedin the post-pyloric region and in the rectum and advanced as deeply aspossible. These locations are explored separately and together as foodssensed in the upper intestine can provide signals to the lower intestineand vice versa. In other embodiments, chemosensory receptor ligands areformulated in a modified release composition for oral delivery thatdelivers the chemosensory receptor ligands to targeted regions orlocations of the intestine. In yet other embodiments, chemosensoryreceptor ligands are formulated for rectal delivery as a suppository,douche, wash, or the like for delivery to targeted regions or locationsof the intestinal tract, e.g., rectum or colon. In some aspects, thedelivery may start anywhere past the taste buds including partial,substantial, predominant release of chemosensory receptor ligands in thestomach so that the natural flow results in the delivery of thechemosensory receptor ligands to one or more regions of the intestine.This delivery method may be combined with targeted delivery to aspecific region of the intestine.

When delivery of chemosensory receptor ligands is to two or more regionsof the gastrointestinal tract, the ligands delivered may be in anyproportion and manner. In some embodiments, certain chemosensoryreceptor ligands are be targeted and delivered to specific regions, suchas for example, sweet receptor ligands to the ileum and umami receptorligands to the colon or, in another example, bitter receptor compoundsto the stomach, sweet receptor ligands to the duodenum and bile salts tothe colon. In other embodiments, chemosensory receptor ligands aredelivered in certain proportions in each region of the gut. In onenon-limiting example, the quantity of one or more chemosensory receptorligands can be delivered 20% to the stomach and 80% to intestine,equally in two or more regions of the intestine or any othercontemplated proportions.

Administration

Combination Therapies

The compositions of the embodiments described herein may beco-administered with known therapies for the treatment of any of theconditions described herein. Co-administration can also provide foradditive or synergistic effects, resulting in the need for lower dosagesof a known therapy, the compositions described herein, or both.Additional benefits of co-administration include the reduction intoxicities associated with any of the known therapies.

Co-administration includes simultaneous administration in separatecompositions, administration at different times in separatecompositions, or administration in a composition in which both agentsare present. Thus, in some embodiments, compositions described hereinand a known therapy are administered in a single treatment. In someembodiments, the compositions described herein and a known therapy areadmixed in a resulting composition. In some embodiments, compositionsdescribed herein and the known therapy are administered in separatecompositions or administrations.

Administration of compositions described herein and known therapiesdescribed herein may be by any suitable means. Administration of acomposition described herein and a second compound (e.g., diabetes drugor obesity drug) may be by any suitable means. If the compositionsdescribed herein and a second compound are administered as separatecompositions, they may be administered by the same route or by differentroutes. If the compositions described herein and a second compound areadministered in a single composition, they may be administered by anysuitable route such as, for example, oral administration. In certainembodiments, compositions of chemosensory ligands and second compoundscan be administered to the same region or different regions of thegastrointestinal tract. For example, chemosensory ligands can beadministered in combination with an anti-diabetic drug to be deliveredto the duodenum, jejunum, ileum, or colon.

Therapies, drugs and compounds useful for the treatment of diabetes,metabolic syndrome (including glucose intolerance, insulin resistance,and dyslipidemia), and/or diseases or conditions associated therewithmay be administered with the chemosensory receptor ligands. Diabetictherapies drugs and compounds include, but are not limited to, thosethat decrease triglyceride levels, decrease glucose levels, and/ormodulate insulin (e.g. stimulate insulin production, mimic insulin,enhance glucose-dependent insulin secretion, suppress glucagon secretionor action, improve insulin action or insulin sensitizers, or areexogenous forms of insulin).

Drugs that decrease triglyceride level include but are not limited toascorbic acid, asparaginase, clofibrate, colestipol, fenofibratemevastatin, pravastatin, simvastatin, fluvastatin, or omega-3 fattyacid. Drugs that decrease LDL cholesterol level include but are notlimited to clofibrate, gemfibrozil, and fenofibrate, nicotinic acid,mevinolin, mevastatin, pravastatin, simvastatin, fluvastatin,lovastatin, cholestyrine, colestipol or probucol.

In another aspect, compositions of the embodiments described herein maybe administered in combination with glucose-lowering compounds.

The medication classes of thiazolidinediones (also called glitazones),sulfonylureas, meglitinides, biguanides, alpha-glucosidase inhibitors,DPP-IV inhibitors, and incretin mimetics have been used as adjunctivetherapies for hyperglycemia and diabetes mellitus (type 2) and relateddiseases.

Drugs that decrease glucose level include but are not limited toglipizides, glyburides, exenatide (Byetta®), incretins, sitagliptin(Januvia®), pioglitizone, glimepiride, rosiglitazone, metformin,vildagliptin, saxagliptin (Onglyza™), sulfonylureas, meglitinide (e.g.,Prandin®) glucosidase inhibitor, biguanides (e.g., Glucophage®),repaglinide, acarbose, troglitazone, nateglinide, natural, synthetic orrecombinant insulin and derivatives thereof, and amylin and amylinderivatives. In certain instances, chemosensory receptor ligandcompositions provided herein are used in combination with biguanides.Biguanides include metformin, phenformin, buformin and relatedcompounds. In certain instances, chemosensory receptor ligandcompositions provided herein are used in combination with metformin.

When administered sequentially, the combination may be administered intwo or more administrations. In an alternative embodiment, it ispossible to administer one or more chemosensory receptor ligands and oneor more additional active ingredients by different routes. The skilledartisan will also recognize that a variety of active ingredients may beadministered in combination with one or more chemosensory receptorligands that may act to augment or synergistically enhance the controlprevention, amelioration, attenuation, or treatment of obesity or eatingdisorders or conditions.

According to the methods provided herein, when co-administered with atleast one other obesity reducing (or anti-obesity) or weight reducingdrug, a chemosensory receptor ligand(s) may be: (1) co-formulated andadministered or delivered simultaneously in a combined formulation; (2)delivered by alternation or in parallel as separate formulations; or (3)by any other combination therapy regimen known in the art. Whendelivered in alternation therapy, the methods provided may compriseadministering or delivering the active ingredients sequentially, e.g.,in separate solution, emulsion, suspension, tablets, pills or capsules,or by different injections in separate syringes. In general, duringalternation therapy, an effective dosage of each active ingredient isadministered sequentially, i.e., serially, whereas in simultaneoustherapy, effective dosages of two or more active ingredients areadministered together. Various sequences of intermittent combinationtherapy may also be used.

In certain embodiments, compositions provided herein may be used withother commercially available diet aids or other anti-obesity agents,such as, by way of example, PYY and PYY agonists, GLP-1 and GLP-1agonists, a DPPIV inhibitor, CCK and CCK agonists, exendin and exendinagonists, GIP and GIP agonists, amylin and amylin agonists, ghrelinmodulators (e.g., inhibitors) and leptin and leptin agonists. In certaininstances, chemosensory receptor ligand compositions provided herein areused in combination with amylin, amylin agonists or mimetics. Exemplaryamylin agonists or mimetics include pramlintide and related compounds.In certain instances, chemosensory receptor ligand compositions providedherein are used in combination with leptin, leptin agonists or mimetics.Additional leptin agonists or mimetics can be identified using themethods described by U.S. Pat. No. 7,247,427 which is incorporated byreference herein. In further instances, chemosensory receptor ligandcompositions provided herein increase leptin sensitivity and increaseeffectiveness of leptin, leptin agonists or mimetics.

Additional anti-obesity agents for use in the methods provided that arein current development are also of interest in the methods of thepresent invention. Other anti-obesity agents include alone or anycombination of phentermine, fenfluramine, sibutramine, rimonabant,topiramate, zonisamide bupropion, naltrexone, lorcaserin, and orlistat.Therapies, drugs and compounds useful for the treatment of weight loss,binge eating, food addictions and cravings may be administered with thecompositions described herein. For example, the subject may further beadministered at least one other drug which is known to suppress hungeror control appetite. Such therapies drugs and compounds include but arenot limited to phenteramines such as Meridia® and Xenical®. Additionaltherapies, drugs and compounds are known in the art and contemplatedherein.

As such, in one aspect, the chemosensory receptor ligands may be used aspart of a combination therapy for the control, prevention or treatmentof obesity or eating disorders or conditions. Compounds used as part ofa combination therapy to treat obesity or reduce weight include, but arenot limited to, central nervous system agents that affectneurotransmitters or neural ion channels, including antidepressants(bupropion), noradrenalin reuptake inhibitors (GW320659), selectiveserotonin 2c receptor agonists, selective 5HT 2c receptor agonists,antiseizure agents (topiramate, zonisamide), some dopamine antagonists,and cannabinoid-1 receptor antagonists (CB-1 receptor antagonists)(rimonabant); leptin/insulin/central nervous system pathway agents,including leptin analogues, leptin transport and/or leptin receptorpromoters, ciliary neurotrophic factor (Axokine), neuropeptide Y andagouti-related peptide antagonists, pro-opiomelanocortin and cocaine andamphetamine regulated transcript promoters,.alpha.-melanocyte-stimulating hormone analogues, melanocoritin-4receptor agonists, and agents that affect insulin metabolism/activity,which include protein-tyrosine phosphatase-1B inhibitors, peroxisomeproliferator activated receptor-.gamma. receptor antagonists,short-acting bromocriptine (ergoset), somatostatin agonists(octreotide), and adiponectin/Acrp30 (Famoxin or Fatty Acid MetabolicOxidation Inducer); gastrointestinal-neural pathway agents, includingthose that increase cholecystokinin activity (CCK), PYY activity, NPYactivity, and PP activity, increase glucagon-like peptide-1 activity(exendin 4, liraglutide, dipeptidyl peptidase IV inhibitors), and thosethat decrease ghrelin activity, as well as amylin analogues(pramlintide); agents that may increase resting metabolic rate(selective β-3 stimulators/agonist, uncoupling protein homologues, andthyroid receptor agonists); other more diverse agents, including melaninconcentrating hormone antagonists, phytostanol analogues, functionaloils, P57, amylase inhibitors, growth hormone fragments, syntheticanalogues of dehydroepiandrosterone sulfate, antagonists of adipocyte11B-hydroxysteroid dehydrogenase type 1 activity,corticotropin-releasing hormone agonists, inhibitors of fatty acidsynthesis (cerulenin and C75), carboxypeptidase inhibitors,indanone/indanols, aminosterols (trodusquemine/trodulamine), and othergastrointestinal lipase inhibitors (ATL962); amphetamines, such asdextroamphetamine; other sympathomimetic adrenergic agents, includingphentermine, benzphetamine, phendimetrazine, mazindol, anddiethylpropion.

Other compounds include ecopipam; oxyntomodulin (OM); inhibitors ofglucose-dependent insulinotropic polypeptide (GIP); gastrin-releasingpeptide; neuromedin B; enterostatin; amfebutamone, SR-58611; CP-045598;AOD-0604; QC-BT16; rGLP-1; 1426 (HMR-1426); N-5984; ISIS-113715;solabegron; SR-147778; Org-34517; melanotan-II; cetilistat; c-2735;c-5093; c-2624; APD-356; radafaxine; fluasterone; GP-389255; 856464;S-2367; AVE-1625; T-71; oleoyl-estrone; peptide YY [3-36] intranasal;androgen receptor agonists; PYY 3-36; DOV-102677; tagatose; SLV-319;1954 (Aventis Pharma AG); oxyntomodulin, Thiakis; bromocriptine, PLIVA;diabetes/hyperlipidemia therapy, Yissum; CKD-502; thyroid receptor betaagonists; beta-3 adrenoceptor agonist; CDK-A agonists; galaninantagonist; dopamine D1/D2 agonists; melanocortin modulators;verongamine; neuropeptide Y antagonists; melanin-concentrating hormonereceptor antagonists; dual PPAR alpha/gamma agonists; CGEN-P-4; kinaseinhibitors; human MCH receptor antagonists; GHS-R antagonists; ghrelinreceptor agonists; DG70 inhibitors; cotinine; CRF-BP inhibitors;urocortin agonists; UCL-2000; impentamine; .beta.-3 adrenergic receptor;pentapeptide MC4 agonists; trodusquemine; GT-2016; C-75; CPOP; MCH-1receptor antagonists; RED-103004; aminosterols; orexin-1 antagonists;neuropeptide Y5 receptor antagonists; DRF-4158; PT-15; PTPaseinhibitors; A37215; SA-0204; glycolipid metabolites; MC-4 agonist;produlestan; PTP-1B inhibitors; GT-2394; neuropeptide Y5 antagonists;melanocortin receptor modulators; MLN-4760; PPAR gamma/delta dualagonists; NPY5RA-972; 5-HT2C receptor agonist; neuropeptide Y5 receptorantagonists (phenyl urea analogs); AGRP/MC4 antagonists; neuropeptide Y5antagonists (benzimidazole); glucocorticoid antagonists; MCHR1antagonists; Acetyl-CoA carboxylase inhibitors; R-1496; HOB1 modulators;NOX-B11; peptide YY 3-36 (eligen); 5-HT 1 modulators; pancreatic lipaseinhibitors; GRC-1087; CB-1 antagonists; MCH-1 antagonists; LY-448100;bombesin BRS3 agonists; ghrelin antagonists; MC4 antagonists;stearoyl-CoA desaturase modulators; H3 histamine antagonists; PPARpanagonists; EP-01492; hormone-sensitive lipase inhibitors; fattyacid-binding protein 4 inhibitors; thiolactone derivatives; proteintyrosine phosphatase 1B inhibitors; MCH-1 antagonist; P-64; PPAR gammaligands; melanin concentrating hormone antagonists; thiazolegastroprokinetics; PA-452; T-226296; A-331440; immunodrug vaccines;diabetes/obesity therapeutics (Bioagency, Biofrontera Discovery GmbH);P-7 (Genfit); DT-011 M; PTP1B inhibitor; anti-diabetic peptideconjugates; KATP agonists; obesity therapeutics (Lexicon); 5-HT2agonists; MCH-1 receptor antagonists; GMAD-1/GMAD-2; STG-a-MD;neuropeptide Y antagonist; angiogenesis inhibitors; G protein-coupledreceptor agonists; nicotinic therapeutics (ChemGenex); anti-obesityagents (Abbott); neuropeptide Y modulators; melanin concentratinghormone; GW-594884A; MC-4R agonist; histamine H3 antagonists; orphanGPCR modulators; MITO-3108; NLC-002; HE-2300; IGF/IBP-2-13; 5-HT2Cagonists; ML-22952; neuropeptide Y receptor antagonists; AZ-40140;anti-obesity therapy (Nisshin Flour); GNTI; melanocortin receptormodulators; alpha-amylase inhibitors; neuropeptide Y1 antagonist; beta-3adrenoceptor agonists; ob gene products (Eli Lilly & Co.); SWR-0342-SA;beta-3 adrenoceptor agonist; SWR-0335; SP-18904; oral insulin mimetics;beta 3 adrenoceptor agonists; NPY-1 antagonists; .beta.-3 agonists;obesity therapeutics (7TM Pharma); 1 lbeta-hydroxysteroid dehydrogenase(HSD) 1 inhibitors; QRX-431; E-6776; RI-450; melanocortin-4 antagonists;melanocortin 4 receptor agonists; obesity therapeutics (CuraGen); leptinmimetics; A-74498; second-generation leptin; NBI-103; CL-314698;CP-114271; beta-3 adrenoceptor agonists; NMI-8739; UCL-1283; BMS-192548;CP-94253; PD-160170; nicotinic agonist; LG-100754; SB-226552; LY-355124;CKD-711; L-751250; PPAR inhibitors; G-protein therapeutics; obesitytherapy (Amylin Pharmaceuticals Inc.); BW-1229; monoclonal antibody(ObeSys/CAT); L-742791; (S)-sibutramine; MBU-23; YM-268; BTS-78050;tubby-like protein genes; genomics (eating disorders; Allelix/Lilly);MS-706; GI-264879A; GW-409890; FR-79620 analogs; obesity therapy(Hybrigenics SA); ICI-198157; ESP-A; 5-HT2C agonists; PD-170292;AIT-202; LG-100641; GI-181771; anti-obesity therapeutics (Genzyme);leptin modulator; GHRH mimetics; obesity therapy (YamanouchiPharmaceutical Co. Ltd.); SB-251023; CP-331684; BIBO-3304;cholesten-3-ones; LY-362884; BRL-48962; NPY-1 antagonists;A-71378;®-didesmethylsibutramine; amide derivatives; obesitytherapeutics (Bristol-Myers Squibb Co.); obesity therapeutics (LigandPharmaceuticals Inc.); LY-226936; NPY antagonists; CCK-A agonists;FPL-14294; PD-145942; ZA-7114; CL-316243; SR-58878; R-1065; BIBP-3226;HP-228; talibegron; FR-165914; AZM-008; AZM-016; AZM-120; AZM-090;vomeropherin; BMS-187257; D-3800; AZM-131; gene discovery (Axys/Glaxo);BRL-26830A; SX-013; ERR modulators; adipsin; AC-253; A-71623; A-68552;BMS-210285; TAK-677; MPV-1743; obesity therapeutics (Modex); GI-248573;AZM-134; AZM-127; AZM-083; AZM-132; AZM-115; exopipam; SSR-125180;obesity therapeutics (Melacure Therapeutics AB); BRL-35135; SR-146131;P-57; AZM-140; CGP-71583A; RF-1051; BMS-196085; manifaxine; beta-3agonists; DMNJ (Korea Research Institute of Bioscience andBiotechnology); BVT-5182; LY-255582; SNX-024; galanin antagonists;neurokinin-3 antagonists; dexfenfluramine; mazindol; diethylpropion;phendimetrazine; benzphetamine; amfebutmone; sertraline; metformin;AOD-9604; ATL-062; BVT-933; GT389-255; SLV319; HE-2500; PEG-axokine;L-796568; and ABT-239.

In some embodiments, compounds for use in combination with achemosensory receptor ligand composition provided herein includerimonabant, sibutramine, orlistat, PYY or an analog thereof, CB-1antagonist, leptin, phentermine, and exendin analogs. Exemplary dosingranges include phentermine resin (30 mg in the morning), fenfluraminehydrochloride (20 mg three times a day), and a combination ofphentermine resin (15 mg in the morning) and fenfluramine hydrochloride(30 mg before the evening meal), and sibutramine (10-20 mg). Weintraubet al. (1984) Arch. Intern. Med. 144:1143-1148.

In some embodiments, a chemosensory receptor ligand composition providedherein is used as an adjunctive therapy to a bariatric surgicalprocedure. Bariatric surgery is a procedure for weight loss and relatesto modifications with the gastrointestinal tract and includes suchprocedures as gastric banding, sleeve gastrectomy, GI bypass procedure(e.g., roux en Y, biliary duodenal bypass, loop gastric bypass),intragastric balloon, vertical banded, gastroplasty, endoluminal sleeve,biliopancreatic diversion, and the like. In certain instances, achemosensory receptor ligand composition is adjunctive to gastricbanding. In certain instances, a chemosensory receptor ligandcomposition is adjunctive to GI bypass procedures. In yet otherinstances, a chemosensory receptor ligand composition is adjunctive tosleeve gastrectomy. In certain embodiments, a chemosensory receptorligand composition as an adjunctive therapy to bariatric surgery isadministered prior to the bariatric procedure. In certain embodiments, achemosensory receptor ligand composition as an adjunctive therapy tobariatric surgery is administered after the bariatric procedure. Incertain instances, when used as adjunctive therapy, the dosage andamounts of a chemosensory receptor ligand composition may be adjusted asneeded with respect to the bariatric procedure. For example, amounts ofa chemosensory receptor ligand composition administered as an adjuncttherapy to a bariatric procedure may be reduced by one-half of normaldosages or as directed by a medical professional.

Combination therapy can be exploited, for example, in modulatingmetabolic syndrome (or treating metabolic syndrome and its relatedsymptoms, complications and disorders), wherein chemosensory receptorligand compositions provided herein can be effectively used incombination with, for example, the active agents discussed above formodulating, preventing or treating diabetes, obesity, hyperlipidemia,atherosclerosis, and/or their respective related symptoms, complicationsand disorders.

Formulations

Formulations for the compositions provided herein include those suitablefor oral or rectal administration, and administration although the mostsuitable route can depend upon for example the condition and disorder ofthe recipient. The formulations can conveniently be presented in unitdosage form and can be prepared by any of the methods well known in theart of pharmacy. All methods include the step of bringing intoassociation the active ingredient with the carrier which constitutes oneor more accessory ingredients.

Formulations suitable for oral administration can be presented asdiscrete units such as capsules, cachets or tablets each containing apredetermined amount of the active ingredient; as a powder or granules;as a solution or a suspension in an aqueous liquid or a non-aqueousliquid; or as an oil-in-water liquid emulsion or a water-in-oil liquidemulsion.

Composition preparations which can be used orally include tablets,push-fit capsules made of gelatin, as well as soft, sealed capsules madeof gelatin and a plasticizer, such as glycerol or sorbitol. Tablets canbe made by compression or molding, optionally with one or more accessoryingredients. Compressed tablets can be prepared by compressing in asuitable machine the active ingredient in a free-flowing form such as apowder or granules, optionally mixed with binders (e.g., povidone,gelatin, hydroxypropylmethyl cellulose), inert diluents, preservative,disintegrant (e.g., sodium starch glycolate, cross-linked povidone,cross-linked sodium carboxymethyl cellulose) or lubricating, surfaceactive or dispersing agents. Molded tablets can be made by molding in asuitable machine a mixture of the powdered compound moistened with aninert liquid diluent. The tablets can optionally be coated or scored andcan be formulated so as to provide slow or controlled release of theactive ingredient therein. Tablets can optionally be provided with anenteric coating, to provide release in parts of the gut other than thestomach. All formulations for oral administration should be in dosagessuitable for such administration. The push-fit capsules can contain theactive ingredients in admixture with filler such as lactose, binderssuch as starches, and/or lubricants such as talc or magnesium stearateand, optionally, stabilizers. In soft capsules, the active compounds canbe dissolved or suspended in suitable liquids, such as fatty oils,liquid paraffin, or liquid polyethylene glycols. In addition,stabilizers can be added. Dragee cores are provided with suitablecoatings. For this purpose, concentrated sugar solutions can be used,which can optionally contain gum arabic, talc, polyvinyl pyrrolidone,carbopol gel, polyethylene glycol, and/or titanium dioxide, lacquersolutions, and suitable organic solvents or solvent mixtures. Dyestuffsor pigments can be added to the tablets or Dragee coatings foridentification or to characterize different combinations of activecompound doses.

For buccal or sublingual administration, the compositions can take theform of tablets, lozenges, pastilles, or gels formulated in conventionalmanner. Such compositions can comprise the active ingredient in aflavored basis such as sucrose and acacia or tragacanth. Suchcompositions can be formulated to delivery chemosensory receptor ligandsto a desired area in the gastrointestional system.

It should be understood that in addition to the ingredients particularlymentioned above, the compounds and compositions described herein caninclude other agents conventional in the art having regard to the typeof formulation in question, for example those suitable for oraladministration can include flavoring agents.

The compositions described herein can also contain chemosensory receptorligands in a form suitable for oral use, for example, as tablets,troches, lozenges, aqueous or oily suspensions, dispersible powders orgranules, emulsions, hard or soft capsules, or syrups or elixirs.Compositions intended for oral use can be prepared according to anymethod known to the art for the manufacture of pharmaceuticalcompositions, and such compositions can contain one or more agentsselected from, by way of non-limiting example, sweetening agents,flavoring agents, coloring agents and preserving agents in order toprovide pharmaceutically elegant and palatable preparations.

Tablets contain the active ingredient in admixture with pharmaceuticallyacceptable excipients which are suitable for the manufacture of tablets.These excipients can be, for example, inert diluents, such as calciumcarbonate, sodium carbonate, lactose, calcium phosphate or sodiumphosphate; granulating and disintegrating agents, such asmicrocrystalline cellulose, sodium crosscarmellose, corn starch, oralginic acid; binding agents, for example starch, gelatin,polyvinyl-pyrrolidone or acacia, and lubricating agents, for example,magnesium stearate, stearic acid or talc. The tablets can be un-coatedor coated by known techniques to mask the taste of the drug or delaydisintegration and absorption in the gastrointestinal tract and therebyprovide a sustained action over a longer period. For example, a watersoluble taste masking material such as hydroxypropylmethyl-cellulose orhydroxypropylcellulose, or a time delay material such as ethylcellulose, or cellulose acetate butyrate can be employed as appropriate.Formulations for oral use can also be presented as hard gelatin capsuleswherein the active ingredient is mixed with an inert solid diluent, forexample, calcium carbonate, calcium phosphate or kaolin, or as softgelatin capsules wherein the active ingredient is mixed with watersoluble carrier such as polyethyleneglycol or an oil medium, for examplepeanut oil, liquid paraffin, or olive oil.

In various embodiments, the chemosensory receptor ligand compositionsprovided herein are in liquid form. Liquid forms include, by way ofnon-limiting example, neat liquids, solutions, suspensions, dispersions,colloids, foams and the like. In certain instances, liquid forms containalso a nutritional component or base (e.g., derived from milk, yogurt,shake, or juice). In some aspects, the chemosensory receptor ligands aremicronized or as nanoparticles in the liquid form. In certain instances,the chemosensory receptor ligands are coated to mask the tastantproperties. In other instances, the chemosensory receptor ligands arecoated to modify delivery to the intestine and colon.

Aqueous solutions or suspensions contain the active ingredient(s) inadmixture with excipients suitable for the manufacture of aqueoussuspensions. Such excipients are suspending agents, for example sodiumcarboxymethylcellulose, methylcellulose, hydroxypropylmethyl-cellulose,sodium alginate, polyvinyl-pyrrolidone, gum tragacanth and gum acacia;dispersing or wetting agents can be a naturally-occurring phosphatide,for example lecithin, or condensation products of an alkylene oxide withfatty acids, for example polyoxyethylene stearate, or condensationproducts of ethylene oxide with long chain aliphatic alcohols, forexample heptadecaethylene-oxycetanol, or condensation products ofethylene oxide with partial esters derived from fatty acids and ahexitol such as polyoxyethylene sorbitol monooleate, or condensationproducts of ethylene oxide with partial esters derived from fatty acidsand hexitol anhydrides, for example polyethylene sorbitan monooleate.The aqueous solutions or suspensions can also contain one or morepreservatives, for example ethyl, or n-propyl p-hydroxybenzoate, one ormore coloring agents, one or more flavoring agents, and one or moresweetening agents, such as sucrose, saccharin or aspartame. In certaininstances, the flavoring agents are chemosensory receptor ligands.

Oily suspensions can be formulated by suspending the activeingredient(s) in a vegetable oil, for example arachis oil, olive oil,sesame oil or coconut oil, or in mineral oil such as liquid paraffin.The oily suspensions can contain a thickening agent, for examplebeeswax, hard paraffin or cetyl alcohol. Sweetening agents such as thoseset forth above, and flavoring agents can be added to provide apalatable oral preparation. These compositions can be preserved by theaddition of an anti-oxidant such as butylated hydroxyanisol oralpha-tocopherol.

Dispersible powders and granules suitable for preparation of an aqueoussolutions or suspension by the addition of water provide the activeingredient in admixture with a dispersing or wetting agent, suspendingagent and one or more preservatives. Suitable dispersing or wettingagents and suspending agents are exemplified by those already mentionedabove. Additional excipients, for example sweetening, flavoring andcoloring agents, can also be present. These compositions can bepreserved by the addition of an anti-oxidant such as ascorbic acid.

Compositions can also be in the form of an oil-in-water emulsion. Theoily phase can be a vegetable oil, for example olive oil or arachis oil,or a mineral oil, for example liquid paraffin or mixtures of these.Suitable emulsifying agents can be naturally-occurring phosphatides, forexample soy bean lecithin, and esters or partial esters derived fromfatty acids and hexitol anhydrides, for example sorbitan monooleate, andcondensation products of the said partial esters with ethylene oxide,for example polyoxyethylene sorbitan monooleate. The emulsions can alsocontain sweetening agents, flavoring agents, preservatives andantioxidants.

Syrups and elixirs can be formulated with sweetening agents, for exampleglycerol, propylene glycol, sorbitol or sucrose. Such formulations canalso contain a demulcent, a preservative, flavoring and coloring agentsand antioxidant.

Compositions can also be formulated in rectal compositions such assuppositories or retention enemas, e.g., containing conventionalsuppository bases such as cocoa butter, polyethylene glycol, or otherglycerides. These compositions can be prepared by mixing the inhibitorswith a suitable non-irritating excipient which is solid at ordinarytemperatures but liquid at the rectal temperature and will thereforemelt in the rectum to release the drug. Such materials include cocoabutter, glycerinated gelatin, hydrogenated vegetable oils, mixtures ofpolyethylene glycols of various molecular weights and fatty acid estersof polyethylene glycol.

The composition can, for example, be in a form suitable for oraladministration as a tablet, capsule, cachet, pill, lozenge, powder orgranule, sustained release formulations, solution, liquid, orsuspension. The pharmaceutical composition can be in unit dosage formssuitable for single administration of precise dosages. Thepharmaceutical composition will include a conventional pharmaceuticalcarrier or excipient and the compound according to the invention as anactive ingredient. In addition, it can include other medicinal orpharmaceutical agents, carriers, adjuvants, etc.

Suitable carriers include inert diluents or fillers, water and variousorganic solvents. The compositions can, if desired, contain additionalingredients such as flavorings, binders, excipients and the like. Thusfor oral administration, tablets containing various excipients, such ascitric acid can be employed together with various disintegrants such asstarch or other cellulosic material, alginic acid and certain complexsilicates and with binding agents such as sucrose, gelatin and acacia.Additionally, lubricating agents such as magnesium stearate, sodiumlauryl sulfate and talc are often useful for tableting purposes. Otherreagents such as an inhibitor, surfactant or solubilizer, plasticizer,stabilizer, viscosity increasing agent, or film forming agent can alsobe added. Solid compositions of a similar type can also be employed insoft and hard filled gelatin capsules. Materials include lactose or milksugar and high molecular weight polyethylene glycols. When aqueoussuspensions or elixirs are desired for oral administration the activecompound therein can be combined with various sweetening or flavoringagents, coloring matters or dyes and, if desired, emulsifying agents orsuspending agents, together with diluents such as water, ethanol,propylene glycol, glycerin, or combinations thereof.

Also contemplated within the invention are food compositions, includingmedical food compositions and formulations containing the compositionsof the invention described herein, as well as nutritional or dietarysupplements incorporating the compositions of the invention. Foods, suchas medical foods, incorporating the compositions of the inventioninclude edible forms such as bars, candies, powders, gels, and liquids.The medical food compositions can be formulated to control the amountsand types of chemosensory receptor ligands as well as the content ofother edible additives and ingredients (e.g., carbohydrates, proteins,fats, fillers, excipients). Exemplary medical food compositions include,but are not limited to, bars with defined and/or limited metabolites andnonmetabolized chemosensory receptor ligands. Edible candies, gels, andliquids can also be formulated with defined ingredients as well as thecompositions described herein.

Modified Release Formulations

In various embodiments, the methods and compositions directed tochemosensory receptor ligand(s) are provided in the form of controlled,sustained, or extended release formulations, known collectively as“modified release” formulations. Compositions can be administered bymodified release means or by delivery devices that are well known tothose of ordinary skill in the art. Examples include, but are notlimited to, those described in U.S. Pat. Nos. 3,845,770; 3,916,899;3,536,809; 3,598,123; 4,008,719; 5,674,533; 5,059,595; 5,591,767;5,120,548; 5,073,543; 5,639,476; 5,354,556; and 5,733,566. Such dosageforms can be used to provide modified release of one or more activeingredients using, for example, hydropropylmethyl cellulose, otherpolymer matrices, gels, permeable membranes, osmotic systems, multilayercoatings, microparticles, liposomes, microspheres, or a combinationthereof to provide the desired release profile in varying proportions.Suitable modified release formulations known to those of ordinary skillin the art, including those described herein, can be readily selectedfor use with the active ingredients of the invention. The invention thusencompasses single unit dosage forms suitable for oral administrationsuch as, but not limited to, tablets, capsules, gelcaps, and capletsthat are adapted for controlled- or sustained-release.

Many strategies can be pursued to obtain modified release in which therate of release outweighs, if any, the rate of metabolism of thechemosensory receptor ligands and/or the location of the release iscontrolled. For example, modified release can be obtained by theappropriate selection of formulation parameters and ingredients (e.g.,appropriate controlled release compositions and coatings). Examplesinclude single or multiple unit tablet or capsule compositions, oilsolutions, suspensions, emulsions, microcapsules, microspheres,nanoparticles, patches, and liposomes. The release mechanism can becontrolled such that the compounds are released at period intervals, therelease could be simultaneous, a delayed release of one of the agents ofthe combination can be affected, when the early release of oneparticular agent is preferred over the other, or the location of therelease is controlled (e.g., release in the lower intestine tract, upperintestine tract, or both, depending upon the number and type ofcompositions to be administered, the desired effect of the compositions,and the desired location of release for each ligand). Different deliverysystems described herein can also be combined to release at an onset ofmultiple period intervals (e.g., about 30 minutes, about 120 minutes,about 180 minutes and about 240 minutes after oral administration) or atdifferent locations (e.g., release in the lower intestine tract, upperintestine tract, the duodenum, jejunum, ileum, caecum, colon, and/orrectum) or a combination thereof. For example, a pH dependent system canbe combined with a timed release system or any other system describedherein to achieve a desired release profile.

In some embodiments, the modified release systems are formulated torelease a chemosensory receptor ligand(s) at a duration of about 30minutes, about 40 minutes, about 50 minutes, about 60 minutes, about 70minutes, about 80 minutes, about 90 minutes, about 100 minutes, about110 minutes, about 120 minutes, about 130 minutes, about 140 minutes,about 150 minutes, about 160 minutes, about 170 minutes, about 180minutes, about 190 minutes, about 200 minutes, about 210 minutes, about220 minutes, about 230 minutes, about 240 minutes, about 250 minutes,about 260 minutes, about 270 minutes, about 280 minutes, about 290minutes, about 300 minutes, about 310 minutes, about 320 minutes, about330 minutes, about 340 minutes, about 350 minutes, about 360 minutes,about 370 minutes, about 380 minutes, about 390 minutes, about 400,about 400, about 410, or about 420 minutes subsequent to onset of therelease. In embodiments with multiple releases, modified release systemsare formulated to release at more than one durations of time atdifferent time points.

In various embodiments, the chemosensory receptor ligand compositions(s)are provided in the form of modified release formulations coupled withan immediate release component in a unitary dosage form. The immediaterelease component can be a can be formulated by any known method such asa layer that envelops the modified release component or the like.Exemplary ratios of immediate release (“IR”) of an active agent to amodified release (“MR”) of an active agent are about 10% IR to about 90%MR, about 15% IR to about 85% MR, about 20% IR to about 80% MR, about25% IR to about 75% MR, about 30% IR to about 70% MR, about 35% IR toabout 65% MR, about 40% IR to about 60% MR, about 45% IR to about 55%MR, or about 50% IR to about 50% MR. In certain embodiments, theimmediate release of an active agent to modified release of an activeagent is about 25% IR to about 75% MR. In other embodiments, theimmediate release of an active agent to modified release of an activeagent is about 20% IR to about 80% MR. Unitary dosage forms with an IRand MR component include any known formulation including bilayertablets, coated pellets, and the like.

Timed Release Systems

In one embodiment, the release mechanism is a “timed” or temporalrelease (“TR”) system that releases an active agent, for example achemosensory receptor ligand(s), at certain timepoints subsequent toadministration. Timed release systems are well known in the art andsuitable timed release system can include any known excipient and/orcoating. For example, excipients in a matrix, layer or coating can delayrelease of an active agent by slowing diffusion of the active agent intoan environment. Suitable timed release excipients, include but are notlimited to, acacia (gum arabic), agar, aluminum magnesium silicate,alginates (sodium alginate), sodium stearate, bladderwrack, bentonite,carbomer, carrageenan, Carbopol, cellulose, microcrystalline cellulose,ceratonia, chondrus, dextrose, furcellaran, gelatin, Ghatti gum, guargum, galactomannan, hectorite, lactose, sucrose, maltodextrin, mannitol,sorbitol, honey, maize starch, wheat starch, rice starch, potato starch,gelatin, sterculia gum, xanthum gum, Glyceryl behenate (e.g., Compritol888 ato), Gylceryl distearate (e.g. Precirol ato 5), polyethylene glycol(e.g., PEG 200-4500), polyethylene oxide, adipic acid, gum tragacanth,ethyl cellulose (e.g., ethyl cellulose 100), ethylhydroxyethylcellulose, ethylmethyl cellulose, methyl cellulose, hydroxyethylcellulose, hydroxyethylmethyl cellulose (e.g., K100LV, K4M, K15M),hydroxypropyl cellulose, poly(hydroxyethyl methacrylate), celluloseacetate (e.g. cellulose acetate CA-398-10 NF), cellulose acetatephthalate, cellulose acetate propionate, cellulose acetate butyrate,hydroxypropyl methyl cellulose acetate succinate, hydroxypropyl methylcellulose phthalate, cellulose butyrate, cellulose nitrate,oxypolygelatin, pectin, polygeline, povidone, propylene carbonate,polyandrides, methyl vinyl ether/maleic anhydride copolymer (PVM/MA),poly(methoxyethyl methacrylate), poly(methoxyethoxyethyl methacrylate),hydroxypropyl cellulose, hydroxypropylmethyl cellulose, sodiumcarboxymethyl-cellulose (CMC), silicon dioxide, vinyl polymers, e.g.polyvinyl pyrrolidones (PVP: povidone), polyvinyl acetates, or polyvinylacetate phthalates and mixtures, Kollidon SR, acryl derivatives (e.g.polyacrylates, e.g. cross-linked polyacrylates, methycrylic acidcopolymers), Splenda® (dextrose, maltodextrin and sucralose) orcombinations thereof. The timed release excipient may be in a matrixwith active agent, in another compartment or layer of the formulation,as part of the coating, or any combination thereof. Varying amounts ofone or more timed release excipients may be used to achieve a designatedrelease time.

In some embodiments, the timed release systems are formulated to releasea chemosensory receptor ligand(s) at an onset of about 5 minutes, about10 minutes, about 20 minutes, about 30 minutes, about 40 minutes, about50 minutes, about 60 minutes, about 70 minutes, about 80 minutes, about90 minutes, about 100 minutes, about 110 minutes, about 120 minutes,about 130 minutes, about 140 minutes, about 150 minutes, about 160minutes, about 170 minutes, about 180 minutes, about 190 minutes, about200 minutes, about 210 minutes, about 220 minutes, about 230 minutes,about 240 minutes, about 250 minutes, about 260 minutes, about 270minutes, about 280 minutes, about 290 minutes, about 300 minutes, about310 minutes, about 320 minutes, about 330 minutes, about 340 minutes,about 350 minutes, about 360 minutes, about 370 minutes, about 380minutes, about 390 minutes, about 400, about 400, about 410, or about420 minutes subsequent to administration. In embodiments with multiplereleases, timed release systems are formulated to release at more thanone time point. In certain embodiments, the timed release systems areformulated to release at an onset of about 10 minutes, about 30 minutes,about 120 minutes, about 180 minutes and about 240 minutes afteradministration. In other embodiments o the timed release systems areformulated to release at an onset of about 5 to about 45 minutes, about105 to about 135 minutes, about 165 to about 195 minutes, about 225 toabout 255 minutes or a combination of times thereof followingadministration to a subject.

In various embodiments, the methods and compositions directed tochemosensory receptor ligand(s) are provided in the form of timedrelease formulations coupled with an immediate release component in aunitary dosage form. The immediate release component can be a can beformulated by any known method such as a layer that envelops the timedrelease component or the like. The timed release component can beformulated to release at exemplary times previously described. Exemplaryratios of immediate release (“IR”) of an active agent to a timed release(“TR”) of an active agent are about 10% IR to about 90% TR, about 15% IRto about 85% TR, about 20% IR to about 80% TR, about 25% IR to about 75%TR, about 30% IR to about 70% TR, about 35% IR to about 65% TR, about40% IR to about 60% TR, about 45% IR to about 55% TR, or about 50% IR toabout 50% TR. In certain embodiments, the immediate release of an activeagent to timed release of an active agent is about 25% IR to about 75%TR. In other embodiments, the immediate release of an active agent totimed release of an active agent is about 20% IR to about 80% TR.

Enteric Coatings and pH Dependent Systems

The formulation may also be coated with an enteric coating, whichprotects an active agent, for example a chemosensory receptor ligand(s),from degradation in an acidic environment, such as the stomach, andallows a delayed release into a target area, for example the duodenum,for uptake.

The enteric coating may be, as a non-limiting example, wax or wax likesubstance, such as carnauba wax, fatty alcohols, hydrogenated vegetableoils, zein, shellac, sucrose, Arabic gum, gelatin, dextrin, psylliumhusk powder, polymethacrylates, anionic polymethacrylates, mixtures ofpoly(methacrylic acid, methyl methacrylate), polymers or copolymersderived from acrylic and/or methacrylic acid esters, cellulose acetatephthalate, cellulose acetate trimelliate, hydroxypropyl methylcellulosephthalate (HPMCP), cellulose propionate phthalate, cellulose acetatemaleate, polyvinyl alcohol phthalate, hydroxypropyl methylcelluloseacetate succinate (HPMCAS), hydroxypropyl methylcellulosehexahydrophthalate, polyvinyl acetate phthalate, mixtures ofpoly(methacrylic acid, ethyl acrylate), ethylcellulose, methylcellulose,propylcellulose, chitosan succinate, chitosan succinate, polyvinylacetate phthalate (PVAP), polyvinyl acetate polymers carboxymethylethylcellulose and compatible mixtures thereof. In addition, an inactiveintermediate film may be provided between the active agent, for example,a chemosensory receptor ligand(s), and the enteric coating to preventinteraction of the active agent with the enteric coating.

The enteric coatings can be formulated to release the active agent, forexample, a chemosensory receptor ligand(s), at a desired pH usingcombinations of enteric polymers. It is well-known that differentlocations of the gastrointestinal system have specific pHs. For example,the duodenum may correspond to a pH 5.5 environment and the jejunum maycorrespond to pH 6.0 environment. In some embodiments, the entericcoatings are formulated to release a chemosensory receptor ligand(s) atan onset of a pH including about pH 1, about pH 1.5, about pH 2, aboutpH 2.5, about pH 3, about pH 3.5, about pH 4, about pH 4.5, about pH 5,about pH 5.5, about pH 6, about pH 6.5, or about pH 7. In embodimentswith multiple releases, the enteric coatings are formulated to releaseat an onset of two or more pH values. In certain embodiments, theenteric coatings are formulated to release at an onset of pH 5.5, 6.0,6.5 and 7.0. In certain embodiments, the enteric coatings are formulatedto release at an onset of pH 5.5, 6.0 and 6.5. In other embodiments, theenteric coatings are formulated to release at the duodenum, jejunum,ileum, and lower intestine. In yet other embodiments, the entericcoatings are used in combination with other release systems such as atimed release system.

In yet other embodiments, the enteric coatings are used in combinationwith an immediate release/modified release unitary dosage forms. Forexample, an unitary dosage form, such as a bilayer tablet with a 20%IR/80% MR component of chemosensory receptor ligand(s) can be coatedwith an enteric coating that releases at pH 6.5 so that the release isdelayed until the dosage form reaches a pH of 6.5, thereby releasing theIR component immediately and the MR component according to its MRrelease properties. In certain instances, the enteric coatings are usedin combination with an immediate release/timed release unitary dosageforms.

Gastro-Retentive Systems

Described herein are dosage forms exhibiting extended gastric residence,possessing some resistance to the pattern of waves of motility presentin the gastrointestinal tract that serve to propel material through it.This is achieved, in some embodiments, by simultaneously providing thedosage form with a combination of gastric residence extendingcharacteristics, including floatation in gastric fluid, adhesion to themucosal surfaces of the gastrointestinal tract, and swelling to a sizewhich delays passage through the pylorus. In some embodiments, formationof microgels occurs upon exposure to gastric fluid.

With the teachings described herein, those of skill in the art will beable to make and use the compositions encompassed by the methods of thepresent invention. In some embodiments, gastro-retentive(sustained-release) systems described herein are used in the methods ofthe present invention.

Floating Properties

The floating property of the dosage form is designed to have low densityand thus float on gastric fluids until the dosage form eitherdisintegrates (and the resultant particles empty from the stomach) orabsorbs fluid to the point that it no longer floats and can pass moreeasily from the stomach with a wave of motility responsible for gastricemptying.

In some of the embodiments described herein, while the system isfloating on the gastric contents, the active ingredient is releasedslowly at the desired rate from the system. After release of activeingredient, the residual system is emptied from the stomach. The systemmay require minimum gastric contents (at least about 200 mL) needed toachieve proper floating principle, which can be accomplished by takingthe dosage form with a cup of water. Also a minimal level of floatingforce (F) is required to keep the dosage form reliably buoyant on thesurface of the stomach contents/meal.

Depending on the desired properties of the composition, it may be usefulto use one or more of the following systems single- and multiple-unithydrodynamically balanced systems (HBS), single and multiple-unit gasgenerating systems, hollow microspheres, and raft-forming systems.Various factors such as gastrointestinal physiology, dosage formcharacteristics, and patient-related factors will influence the dosageform buoyancy. With the knowledge in the art and the teaching providedherein, skilled artisans will readily know how to implement thesesystems.

The floating dosage forms can be prepared where buoyancy is created viathree possible mechanisms. The first mechanism is the incorporation offormulation components with sufficiently low density to enable floatingon the stomach contents. Such systems need not disintegrate into smallpieces to empty from the stomach, but rather slowly erode, graduallylosing buoyancy and eventually being expelled from the stomach. Thisapproach may be especially useful for active ingredients or other activeingredients administered in low doses (a few hundred milligrams per dayor less) or having low water solubility. However, these properties havelimited utility where higher doses are required or with highly watersoluble active ingredients. In these instances, large amounts of polymerwould be needed to retard drug or active ingredient release. Dependingon the amount of polymer, a capsule dosage form may not be practicabledue to size constraints. Furthermore, homogenous distribution of drugsor other active ingredients in a tablet of this form can be accompaniedby an undesirable, rapid initial release of drug or active ingredient.Again, this is most often seen with very water soluble drugs or activeingredients.

The second mechanism is the formation of a bilayer dosage form where thebuoyancy originates from a separate layer to the active layer. Thisapproach can overcome some of the problems encountered with the systemdiscussed above.

The third mechanism is the incorporation of one or more gas generatingagents. Gas generating agents react with gastric fluid to generate gas.This gas is subsequently entrapped within the dosage form which resultsin floatation in the gastric fluid. This approach may offer improvedcontrol over degree, onset time and persistence of floatation. U.S. Pat.No. 4,844,905, describes a system with a active ingredient loaded coresurrounded by a gas generating layer, which in turn was surrounded by apolymeric layer responsible for controlling active ingredient releasefrom the system. In some embodiments, the gas generating component uponinteraction with gastric fluid generates carbon dioxide or sulfurdioxide that becomes entrapped within the hydrated microgel matrix ofthe gelling agent.

The gas generating components useful in the compositions describedherein include, but are not limited to, a combination of one or more ofbicarbonate and carbonate salts of Group I and Group II metals,including sodium, potassium, and calcium water soluble carbonates,sulfites and bicarbonates such as sodium carbonate, sodium bicarbonate,sodium metabisulfite, calcium carbonate. The gas generating componentcan be present in an amount from about 2-50 wt-%.

Floating tablets can have a bulk density less than gastric fluid so thatthey remain buoyant in the stomach without affecting the gastricemptying rate for a prolonged period of time.

Limitations of floating dosage forms include required administrationwith a suitable amount of fluid (normal gastric contents could be aslittle as a few tens of milliliters) and their possible posturedependence. A patient sitting upright may ensure prolonged gastricresidence of a buoyant dosage form, whereas a supine patient might allowready presentation of the floating dosage form to the pylorus and thusallow rapid exit of the dosage form from the stomach (see Timmermans etal, J. Pharm. Sci. 1994, 83, 18-24).

Bioadhesive Properties

Bioadhesive delivery systems are designed to imbibe gastric fluid suchthat the outer layer becomes a viscous, tacky material that adheres tothe gastric mucosa/mucus layer. This increases gastric retention untilthe adhesive forces are weakened for example by continuing hydration ofthe outer layer of the dosage form or by the persistent application ofshear. Polycarbophil has been identified as a suitable polymer foradhesion of orally administered dosage forms to the gastric mucosa, (seeLonger et al, J. Pharm. Sci., 1985, 74, 406-411). It should be notedthat the success observed in animal models with such systems has beenfound to be unreliable in translating to humans due to differences inmucous amounts, consistency and turnover differences between animals andhumans.

As described herein, the combination of bioadhesiveness with low densitymaterials (i.e. less dense than gastric fluid) maintain floating whileprolonging the gastric retention time (GRT) by allowing the compositionto float in the upper region of the stomach. Because the dosage formalso has bioadhesive characteristics, in some embodiments, the dosageform will also attach itself to gastric mucosa.

Swelling Properties

The compositions described herein should be of a size that allows thedosage form to be swallowed. After ingestion, the compositions describedherein swell. In some embodiments, the compositions swell to a size thatprecludes passage through the pylorus until after active ingredientrelease has progressed to a required degree.

The dosage forms described herein can comprise hydrophilic erodiblepolymers. In these embodiments, upon imbibing gastric fluid the dosageform swells over a short period of time to a size that will encourageprolonged gastric retention. This allows for the sustained delivery ofthe active ingredient to the absorption site. In some embodiments, theabsorption site of the active ingredient is in the uppergastrointestinal tract.

When the dosage forms are made of an erodible, hydrophilic polymer(s),they readily erode over a reasonable time period to allow passage fromthe stomach. The time period of expansion is such that this will notoccur in the esophagus and if the dosage form passes into the intestinein a partially swollen state, the erodibility and elastic nature of thehydrated polymer will eliminate the chance of intestinal obstruction bythe dosage form.

Various types of polymers are available to provide systems that willswell and then gradually release active ingredient from the swollendosage forms. For example, active ingredient dissolution dosage formscan comprise linear hydrophilic polymers. Upon hydration, these linearhydrophilic polymers, which do not have a covalently cross-linkedstructure, can form a gelatinous layer on the surface of the dosageform. The thickness and durability of this gelatinous layer depends on anumber of factors such as the concentration, molecular weight andviscosity of the polymer(s) comprising the dosage form. At higherconcentrations the linear polymer chains entangle to a greater degree.This can result in virtual cross-linking and the formation of a strongergel layer. As the swollen linear chains of the hydrophilic polymerdissolve, the gel layer erodes and the active ingredient is released. Inthese embodiments, the rate of dosage form erosion helps control therelease rate of the active ingredient.

Cross-linked polymers such as polyacrylic acid polymer (PAA) may be usedin the dosage form matrix. In the dry state, dosage forms formulatedwith cross-linked polyacrylic acid polymers contain the activeingredient trapped within a glassy core. As the external surface of thetablet is hydrated, it forms a gelatinous layer. It is believed thatthis layer is different than traditional matrices because the hydrogelsare not entangled chains of polymer, but discrete microgels made up ofmany polymer particles. The crosslink network enables the entrapment ofactive ingredients in the hydrogel domains. Because these hydrogels arenot water soluble, they do not dissolve or erode in the same manner aslinear polymers. Instead, when the hydrogel is fully hydrated, osmoticpressure from within works to break up the structure by sloughing offdiscrete pieces of the hydrogel. The active ingredient is able todiffuse through the gel layer at a uniform rate.

Though not wishing to be bound by any particular theory, it ispostulated that as the concentration of the active ingredient increaseswithin the gel matrix and its thermodynamic activity or chemicalpotential increases, the gel layer around the active ingredient coreacts as a rate controlling membrane, which results in a linear releaseof the active ingredient. With these systems, active ingredientdissolution rates are affected by subtle differences in rates ofhydration and swelling of the individual polymer hydrogels. Theseproperties of the polymer hydrogels are dependent on various factorssuch as the molecular structure of the polymers, including crosslinkdensity, chain entanglement, and crystallinity of the polymer matrix.The extent and rate of swelling is also dependent on pH and thedissolution medium. The channels that form between the polymer hydrogelsare also influenced by the concentration of the polymer and the degreeof swelling. Increasing the amount of polymer or the swelling degree ofthe polymer decreases the size of the channels.

Cross-linked polyacrylic acid polymers provide rapid and efficientswelling characteristics in both simulated gastric fluid (SGF) andsimulated intestinal fluid (SIF) and produce dosage forms of excellenthardness and low friability. Moreover, cross-linked polyacrylic acidpolymers may also provide longer dissolution times at lowerconcentrations than other excipients.

Compound solubility is also important to active ingredient release fromdosage forms comprising cross-linked polyacrylic acid polymers. Poorlysoluble compounds tend to partition into the more hydrophobic domains ofthe system, such as the acrylic backbone of the polymer. Highly watersoluble compounds undergo diffusion controlled-release due to the fastdissolution of the active ingredient through the water-filledinterstitial spaces between the microgels.

With the combination of sufficient swelling, floatation and/orbioadhesion properties, the dosage forms described and useful in thepresent invention achieve gastric retention regardless of whether thesubject is in the fed mode or the fasting mode.

One means of achieving a swellable particle is to disperse the activeingredient in a solid matrix formed of a substance that absorbs thegastric fluid and swells as a result of the absorbed fluid. (See., e.g.,U.S. Pat. Nos. 5,007,790, 5,582,837, and 5,972,389, and WO 98/55107.)

Polymer matrices are useful for achieving controlled release of theactive ingredient over a prolonged period of time. Such sustained orcontrolled release is achieved either by limiting the rate by which thesurrounding gastric fluid can diffuse through the matrix and reach theactive ingredient, dissolve the active ingredient and diffuse out againwith the dissolved active ingredient, or by using a matrix that slowlyerodes. (See, e.g., U.S. Pat. Nos. 4,915,952, 5,328,942, 5,451,409,5,783,212, 5,945,125, 6,090,411, 6,120,803, 6,210,710, 6,217,903, and WO96/26718 and WO 97/18814).

U.S. Pat. No. 4,434,153, describes the use of a hydrogel matrix thatimbibes fluid to swell to reach a size encouraging prolonged gastricretention. This matrix surrounds a plurality of tiny pills consisting ofactive ingredient with a release rate controlling wall of fatty acid andwax surrounding each of the pills.

U.S. Pat. Nos. 5,007,790 and 5,582,837, and WO 93/18755, describe aswelling hydrogel polymer with active ingredient particles embeddedwithin it. These particles dissolve once the hydrogel matrix ishydrated. The swollen matrix is of a size to encourage gastric retentionbut only dissolved active ingredient reaches the mucosa and this can bedelivered in a sustained manner. Such a system thus does not insult themucosa with solid particles of irritant active ingredient and issuitable for delivering active ingredient to the upper gastrointestinaltract. These systems only apply in case of active ingredients of limitedwater solubility.

Layered Gastroretentive Systems

The layered gastroretentive active ingredient delivery systems describedin, e.g., U.S. Pat. No. 6,685,962, can be used in the sustained releasedelivery methods described herein. In general, such delivery systemshave an active agent or drug associated with a matrix that is affixed orattached to a membrane. The membrane prevents evacuation from thestomach thereby allowing the active agent/matrix to be retained in thestomach for 3-24 hours.

The matrix/membrane system can be a multilayer system, including but notlimited to a bilayer system. In addition, the matrix/membrane may beadministered as a folded configuration within a capsule, including butnot limited to a gelatin capsule.

The matrix of such delivery systems can be a single- or multi-layeredand have a two- or three-dimensional geometric configuration. The matrixcan comprise a polymer selected from a degradable polymer, including butnot limited to a hydrophilic polymer which is not instantly soluble ingastric fluids, an enteric polymer substantially insoluble at pH lessthan 5.5, a hydrophobic polymer; or any mixture thereof. In addition,the matrix can comprise a non-degradable; or a mixture of at least onedegradable polymer and at least one non-degradable polymer.

The hydrophilic polymers of such delivery systems may be any hydrophilicpolymer, including but not limited to, a protein, a polysaccharide, apolyacrylate, a hydrogel or any derivative thereof. By way of exampleonly, such proteins are proteins derived from connective tissues, suchas gelatin and collagen, or an albumin such as serum albumin, milkalbumin or soy albumin. By way of example only, such polysaccharides aresodium alginate or carboxymethylcellulose. By way of example only, otherhydrophilic polymers may be polyvinyl alcohol, polyvinyl pyrrolidone orpolyacrylates, such as polyhydroxyethylmethacrylate. In addition, thehydrophilic polymer may be cross-linked with a suitable cross-linkingagent. Such cross-linking agents are well known in the art, and include,but are not limited to, aldehydes (e.g. formaldehyde andglutaraldehyde), alcohols, di-, tri- or tetravalent ions (e.g. aluminum,chromium, titanium or zirconium ions), acyl chlorides (e.g. sebacoylchloride, tetraphthaloyl chloride) or any other suitable cross-linkingagent, such as urea, bis-diazobenzidine, phenol-2,4-disulfonyl chloride,1,5-difluoro-2,4-dinitrobenzene, 3,6-bis-(mercuromethyl)-dioxane urea,dimethyl adipimidate, N,N′-ethylene-bis-(iodoacetamide) or N-acetylhomocysteine thiolactone. Other suitable hydrogels and their suitablecross-linking agents are listed, for example, in the Handbook ofBiodegradable Polymers [A. J. Domb, J. Kost & D. M. Weisman, Eds. (1997)Harwood Academic Publishers].

The enteric polymer used in such layered delivery systems is a polymerthat is substantially insoluble in a pH of less than 5.5. By way ofexample only, such enteric polymers include shellac, cellulose acetatephthalate, hydroxypropyl methylcellulose phthalate, hydroxypropylmethylcellulose acetate succinate or methylmethacrylate-methacrylic acidcopolymers.

The non-degradable hydrophobic polymers used in such layered deliverysystems include, but are not limited to, ethylcellulose, acrylicacid-methacrylic acid esters copolymer, polyethylene, polyamide,polyvinylchloride, polyvinyl acetate and mixtures thereof

The degradable hydrophobic polymers used in such layered deliverysystems include, but are not limited to, poly(alpha-hydroxyacids), suchas poly(lactic acid), poly(glycolic acid), copolymers and mixturesthereof.

The membranes used in such layered delivery systems have substantialmechanical strength and may be continuous or non-continuous. Suchmembranes may comprise, by way of example only, cellulose ethers andother cellulose derivatives such as cellulose nitrate, celluloseacetate, cellulose acetate butyrate or cellulose acetate propionate;polyesters, such as polyethylene terephthalate, polystyrene, includingcopolymers and blends of the same; polylactides, including copolymersthereof with p-dioxanone, polyglycolides, polylactidglycolides;polyolefins, including polyethylene, and polypropylene; fluoroplastics,such as polyvinylidene fluoride and polytetrafluoroethylene, includingcopolymers of the same with hexafluoropropylene or ethylene;polyvinylchloride, polyvinylidene chloride copolymers, ethylene vinylalcohol copolymers, polyvinyl alcohols, ammonium-methacrylate copolymersand other polyacrylates and polymethacrylates; polyacrylonitriles;polyurethanes; polyphthalamides; polyamides; polyimides;polyamide-imides; polysulfones; polyether sulfones; polyethylenesulfides; polybutadiene; polymethyl pentene; polyphenylene oxide (whichmay be modified); polyetherimides; polyhydroxyalkanoates; tyrosinederived polyarylates and polycarbonates including polyester carbonates,polyanhydrides, polyphenylene ethers, polyalkenamers, acetal polymers,polyallyls, phenolic polymers, polymelamine formaldehydes, epoxypolymers, polyketones, polyvinyl acetates and polyvinyl carbazoles.

The active agent or compound associated with the matrix may be in aparticulate form or may be in the form of raw powder, or soluted,dispersed or embedded in a suitable liquid, semisolid, micro- ornanoparticles, micro- or nanospheres, tablet, or capsule. The compound,or mixtures of compounds, in any of such forms, may be embedded in atleast one layer of the matrix of the delivery system. Alternatively, ina multi-layered matrix, including but not limited to a bi-layeredmatrix, the active ingredient may be entrapped between any two layers,whether in free form or contained within a compound-containing meanssuch as, by way of example only, in a tablet or a capsule.

Microcapsule Gastroretentive Systems

The microcapsules gastroretentive systems described in U.S. Pat. Nos.6,022,562, 5,846,566 and 5,603,957, can be used in the sustained releasedelivery methods described herein. Microparticles of an active agent ordrug are coated by spraying with a material consisting of a mixture of afilm-forming polymer derivative, a hydrophobic plasticizer, a functionalagent and a nitrogen-containing polymer. The resulting microcapsules areless than or equal to 1000 microns (μm) in size, and in certain casessuch microcapsules are between 100 and 500 microns. These microcapsulesremain in the small intestine for at least 5 hours.

Film-forming polymer derivatives used in such microcapsules include, butare not limited to, ethylcellulose, cellulose acetate, andnon-hydrosoluble cellulose derivates. The nitrogen-containing polymersinclude, but are not limited to, polyacrylamide, poly-N-vinylamide,poly-N-vinyl-lactam and polyvinylpyrrolidone. The plasticizer used insuch microcapsule include, but are not limited to, glycerol esters,phthalates, citrates, sebacates, cetylalcohol esters, castor oil andcutin. The surface-active and/or lubricating agent used in suchmicrocapsule include, but are not limited to, anionic surfactants, suchas by way of example the alkali metal or alkaline-earth metal salts offatty acids, stearic acid and/or oleic acid, nonionic surfactants, suchas by way of example, polyoxyethylenated esters of sorbitan and/orpolyoxyethylenated esters of sorbitan and/or polyoxyethylenatedderivatives of castor oil; and/or lubricants such as stearates, such asby way of example, calcium, magnesium, aluminum stearate, zinc stearate,stearylfumarate, sodium stearylfimarate, and glyceryl behenate.

In one non-limiting example, Chitosan and mixtures of chitosan withcarboxymethylcellulose sodium (CMC-Na) have been used as vehicles forthe sustained release of active ingredients, as described by Inouye etal., Drug Design and Delivery 1: 297-305, 1987. Mixtures of thesecompounds and agents of the combinations of the invention, whencompressed under 200 kg/cm2, form a tablet from which the active agentis slowly released upon administration to a subject. The release profilecan be changed by varying the ratios of chitosan, CMC-Na, and activeagent(s). The tablets can also contain other additives, includinglactose, CaHPO4 dihydrate, sucrose, crystalline cellulose, orcroscarmellose sodium.

In another non-limiting example, Baichwal, in U.S. Pat. No. 6,245,356,describes sustained release oral, solid dosage forms that includesagglomerated particles of a therapeutically active medicament inamorphous form, a gelling agent, an ionizable gel strength enhancingagent and an inert diluent. The gelling agent can be a mixture of axanthan gum and a locust bean gum capable of cross-linking with thexanthan gum when the gums are exposed to an environmental fluid.Preferably, the ionizable gel enhancing agent acts to enhance thestrength of cross-linking between the xanthan gum and the locust beangum and thereby prolonging the release of the medicament component ofthe formulation. In addition to xanthan gum and locust bean gum,acceptable gelling agents that may also be used include those gellingagents well known in the art. Examples include naturally occurring ormodified naturally occurring gums such as alginates, carrageenan,pectin, guar gum, modified starch, hydroxypropylmethylcellulose,methylcellulose, and other cellulosic materials or polymers, such as,for example, sodium carboxymethylcellulose and hydroxypropyl cellulose,and mixtures of the foregoing.

In another non-limiting formulation useful for the combinations of theinvention, Baichwal and Staniforth in U.S. Pat. No. 5,135,757 describe afree-flowing slow release granulation for use as a pharmaceuticalexcipient that includes from about 20 to about 70 percent or more byweight of a hydrophilic material that includes a heteropolysaccharide(such as, for example, xanthan gum or a derivative thereof) and apolysaccharide material capable of cross-linking theheteropolysaccharide (such as, for example, galactomannans, and mostpreferably locust bean gum) in the presence of aqueous solutions, andfrom about 30 to about 80 percent by weight of an inertpharmaceutical-filler (such as, for example, lactose, dextrose, sucrose,sorbitol, xylitol, fructose or mixtures thereof). After mixing theexcipient with a tricyclic compound/corticosteroid combination, orcombination agent, of the invention, the mixture is directly compressedinto solid dosage forms such as tablets. The tablets thus formed slowlyrelease the medicament when ingested and exposed to gastric fluids. Byvarying the amount of excipient relative to the medicament, a slowrelease profile can be attained.

In another non-limiting example, Shell, in U.S. Pat. No. 5,007,790,describes sustained-release oral drug-dosage forms that release a activeingredient in solution at a rate controlled by the solubility of theactive ingredient. The dosage form comprises a tablet or capsule thatincludes a plurality of particles of a dispersion of a limitedsolubility active ingredient in a hydrophilic, water-swellable,crosslinked polymer that maintains its physical integrity over thedosing lifetime but thereafter rapidly dissolves. Once ingested, theparticles swell to promote gastric retention and permit the gastricfluid to penetrate the particles, dissolve active ingredient and leachit from the particles, assuring that active ingredient reaches thestomach in the solution state which is less injurious to the stomachthan solid-state active ingredient. The programmed eventual dissolutionof the polymer depends upon the nature of the polymer and the degree ofcrosslinking. The polymer is nonfibrillar and substantially watersoluble in its uncrosslinked state, and the degree of crosslinking issufficient to enable the polymer to remain insoluble for the desiredtime period, normally at least from about 4 hours to 8 hours up to 12hours, with the choice depending upon the active ingredient incorporatedand the medical treatment involved. Examples of suitable crosslinkedpolymers that may be used in the invention are gelatin, albumin, sodiumalginate, carboxymethyl cellulose, polyvinyl alcohol, and chitin.Depending upon the polymer, crosslinking may be achieved by thermal orradiation treatment or through the use of crosslinking agents such asaldehydes, polyamino acids, metal ions and the like.

In an additional non-limiting example, Silicone microspheres forpH-controlled gastrointestinal drug delivery have been described byCarelli et al., Int. J. Pharmaceutics 179: 73-83, 1999. The microspheresare pH-sensitive semi-interpenetrating polymer hydrogels made of varyingproportions of poly(methacrylic acid-co-methylmethacrylate) (EudragitL100 or Eudragit S100) and crosslinked polyethylene glycol 8000 that areencapsulated into silicone microspheres. Slow-release formulations caninclude a coating which is not readily water-soluble but which is slowlyattacked and removed by water, or through which water can slowlypermeate. Thus, for example, the combinations of the invention can bespray-coated with a solution of a binder under continuously fluidizingconditions, such as describe by Kitamori et al., U.S. Pat. No.4,036,948. Examples of water-soluble binders include pregelatinizedstarch (e.g., pregelatinized corn starch, pregelatinized white potatostarch), pregelatinized modified starch, water-soluble celluloses (e.g.hydroxypropylcellulose, hydroxymethyl-cellulose,hydroxypropylmethyl-cellulose, carboxymethyl-cellulose),polyvinylpyrrolidone, polyvinyl alcohol, dextrin, gum arabicum andgelatin, organic solvent-soluble binders, such as cellulose derivatives(e.g., cellulose acetate phthalate, hydroxypropylmethyl-cellulosephthalate, ethylcellulose).

Combinations of the invention, or a component thereof, with sustainedrelease properties can also be formulated by spray drying techniques.Yet another form of sustained release combinations can be prepared bymicroencapsulation of combination agent particles in membranes which actas microdialysis cells. In such a formulation, gastric fluid permeatesthe microcapsule walls and swells the microcapsule, allowing the activeagent(s) to dialyze out (see, for example, Tsuei et al., U.S. Pat. No.5,589,194). One commercially available sustained-release system of thiskind consists of microcapsules having membranes of acaciagum/gelatine/ethyl alcohol. This product is available from EurandLimited (France) under the trade name Diffucaps™. Microcapsules soformulated can be carried in a conventional gelatine capsule ortabletted. A bilayer tablet can be formulated for a combination of theinvention in which different custom granulations are made for each agentof the combination and the two agents are compressed on a bi-layer pressto form a single tablet.

When desired, formulations can be prepared with enteric coatings adaptedfor sustained or controlled release administration of the activeingredient. A common type of controlled-release formulation that may beused for the purposes of the present invention comprises an inert core,such as a sugar sphere, coated with an inner activeingredient—containing layer and an outer membrane layer controllingactive ingredient release from the inner layer. Other formulations fortargeted release of compounds in the gastrointestinal tract are alsoknown in the art and contemplated for use with the invention describedherein. Exemplary systems for targeting delivery of a substance to theupper and/or lower gastrointestinal tract include the formulations ofthe TIMERx® system. This controlled release formulation system providesfor altered temporal release (SyncroDose™) as well as biphasic release(Geminex®). (See, for example, Staniforth & Baichwal, TIMERx®: novelpolysaccharide composites for controlled/programmed release of activeingredients in the gastrointestinal tract, Expert Opin. Drug Deliv.,2(3): 587-89 (2005)). Using formulations such as these for the inventiondescribed herein, compositions can be created which target the uppergastrointestinal tract, the lower gastrointestinal tract, or both, inaddition to temporally controlling the release of such compounds in anyof these locations.

One non-limiting example of a lower GI delivery formulation comprises atablet for lower GI delivery. The inner composition of the tabletcomprises about 0.01% weight to about 10.0% by weight of a suitableactive ingredient; about 50% by weight to about 98% by weight of ahydrocolloid gum obtainable from higher plants; and about 2% by weightto about 50% by weight of a pharmaceutically acceptable excipient suchas a binder. Other optional materials may be present that will assist inestablishing the desired characteristics of the pharmaceuticalcomposition. These include materials that may enhance absorption of theactive ingredient in the lower GI, may protect the active ingredientagainst degradation, may prevent dissolution, and the like. Optionallysurrounding the inner composition of the tablet is a coating that ispreferably of enteric polymeric material.

The formulation is designed to take advantage of (1) the protectivecharacteristics of the hydrocolloid obtainable from higher plants in theupper GI and (2) the disintegrative characteristics of the hydrocolloidin the lower GI. Thus, the inner composition of the tablet may be one ofseveral designs: (a) it may be a matrix of a therapeutically effectiveamount of the active ingredient uniformly dispersed throughout incombination with a high percentage of the hydrocolloid and a generallylesser amount of other excipients; (b) it may have a core, in which theactive ingredient is concentrated, surrounded by a layer of materialthat is free of the active ingredient and that has a high percentage ofthe hydrocolloid and a generally lesser amount of other excipients; (c)it may have a concentration gradient of the active ingredient such thatthere is a greater amount in the core of the tablet with lesser amountsin multiple layers surrounding the core and very little or no activeingredient in the outer layer. Whether the design of the tablet is thatof (a), (b) or (c) above, the specificity for regional delivery to thelower GI is enhanced by enterically coating the tablet with anappropriate enteric coating material.

Hydrocolloids are obtainable from higher plants. By “higher plant” ismeant an organism of the vegetable kingdom that lacks the power oflocomotion, has cellulose cell walls, grows by synthesis of inorganicsubstances and includes the vascular plants (or tracheophytes) of thedivision Spermatophyta, particularly those of the class Angiospermae.The gums may be extracted from the roots, legumes, pods, berries, bark,etc. Representative hydrocolloid gums obtainable from higher plantsinclude guar gum, gum tragacanth, karaya gum (also referred to as kadayagum) and locust bean gum (also referred to as carob). Others may bereadily apparent to one of skill in the art. See, for example, “TheChemistry of Plant Gums and Mucilages” by Smith and Montgomery from ACSMonograph Series, No. 141, 1959, Reinhold Publishing Company and the18th edition of the Merck Index. A particularly convenient and usefulhydrocolloid is guar gum which is a neutral polysaccharide and consistsof long galactomannan molecules with some side chain attachments. Thehydrocolloids used in the subject invention generally have highviscosity exhibited upon hydration, are normally linear (at least about50% by weight of the compound is the backbone chain), and will normallyhave high molecular weight, usually about 3×10 5 daltons, more usuallygreater than about 1×10 6 daltons. Generally, the hydrocolloid comes asa powdered hydrocolloid gum and exhibits a viscosity at a 1%concentration in a neutral aqueous solution of at least about 75centipoise per second (cps) at 25° C. after 24 hours, using a Brookfieldviscometer (model LDF) with a number 3 spindle at 90 rpms, preferably atleast 1×10 3 cps and most preferably at least about 2×10 3 cps.Generally, the viscosity increases with increasing molecular weight. SeeMeer Corporation, “An Introduction to Polyhydrocolloids.” Hydrocolloidgums most useful are those where the hydrocolloid is a polysaccharidehydrocolloid which is chemically designated as galactomannan.Galactomannans are polysaccharides consisting of long chains of(1→4)-β-D-mannopyranosyl units to which single unit side chains ofα-D-galactopyranosyl are joined by (1→6) linkages. Galactomannans arefound in a variety of plants but differ in molecular size and the numberof D-galactosyl side chains. The galactomannans useful in this inventionare commonly found in the endosperms of the leguminosae.

Galactomannan can be obtained, for example, from the cyamopsistetragonolobus, commonly referred to as guar. This exhibits a percentagemannose residue of about 64% with a percent galactose residue of about36%. Commercially available guar gum is about 66-82% galactomannanpolysaccharide with impurities making up the remainder of thecomposition. According to the National Formulary (NF) standards the guargum may contain up to 15% w water, up to 10% w protein, up to 7% w acidinsoluble material and up to about 1.5% ash. Sources of commerciallyavailable guar gum are Aqualon Company, Wilmington, Del.; MeerCorporation, Cincinnati, Ohio; Stein Hall & Company and TIC Gums, Inc.,Belcamp, Md.

Other hydrocolloids are known in the art. See for example “The Chemistryof Plant Gums and Mucilages” by Smith and Montgomery from the A.C.S.Monograph series, #141, 1959, Reinhold Publishing Co. and the EighteenthEdition of The Merck Index. In general, the amount of the hydrocolloidthat will be used is an amount that allows the composition to traversethe upper GI tract without significant disintegration and withoutreleasing significant amounts of active ingredient in the upper GItract, i.e. to provide a delayed-release profile. Generally, that amountof hydrocolloid will be more than about 50% but less than about 98%.Depending on individual variability, whether a subject has eaten or hasfasted, and other factors, a tablet will traverse the stomach and upperintestinal tract in about 3 to 6 hours. During this time, little activeingredient (less than 20%, preferably less than 10%) is released fromthe tablet of this invention. Once the tablet reaches the lower GI, therelease of the active ingredient is triggered by enzymatic degradationof the galactomannan gum.

One non-limiting example of a formulation for upper gastrointestinaldelivery comprises a free-flowing slow release granulation for use as apharmaceutical excipient that includes from about 20 to about 70 percentor more by weight of a hydrophilic material that includes aheteropolysaccharide (such as, for example, xanthan gum or a derivativethereof) and a polysaccharide material capable of cross-linking theheteropolysaccharide (such as, for example, galactomannans, and mostpreferably locust bean gum) in the presence of aqueous solutions, andfrom about 30 to about 80 percent by weight of an inertpharmaceutical-filler (such as, for example, lactose, dextrose, sucrose,sorbitol, xylitol, fructose or mixtures thereof). After mixing theexcipient with the compounds of the invention, the mixture is directlycompressed into solid dosage forms such as tablets. The tablets thusformed slowly release the medicament when ingested and exposed togastric fluids. By varying the amount of excipient relative to themedicament, a slow release profile can be attained.

One non-limiting example of a sustained gastrointestinal deliveryformulation comprises a plurality of particles of a dispersion of alimited solubility active ingredient in a hydrophilic, water-swellable,crosslinked polymer that maintains its physical integrity over thedosing lifetime but thereafter rapidly dissolves. Once ingested, theparticles swell to promote gastric retention and permit the gastricfluid to penetrate the particles, dissolve active ingredient and leachit from the particles, assuring that active ingredient reaches thestomach in the solution state which is less injurious to the stomachthan solid-state active ingredient. The programmed eventual dissolutionof the polymer depends upon the nature of the polymer and the degree ofcrosslinking. The polymer is nonfibrillar and substantially watersoluble in its uncrosslinked state, and the degree of crosslinking issufficient to enable the polymer to remain insoluble for the desiredtime period. Examples of suitable crosslinked polymers that may be usedin the invention are gelatin, albumin, sodium alginate, carboxymethylcellulose, polyvinyl alcohol, and chitin. Depending upon the polymer,crosslinking may be achieved by thermal or radiation treatment orthrough the use of crosslinking agents such as aldehydes, polyaminoacids, metal ions and the like.

Formulations for upper intestinal delivery, lower intestinal delivery orboth are known in the art. Targeting of active ingredients to variousregions of the gut is described, e.g., in The Encyclopedia ofPharmaceutical Technology, by James Swarbrick and James Boylan, InformaHealth Care, 1999, at pp. 287-308. Any suitable formulation forgastrointestinal delivery for site-specific delivery and/or specifictemporal delivery (i.e. delayed, controlled, extended, or sustainedrelease) can be used with the invention and is contemplated herein. Inone non-limiting example, a single composition comprises a firstformulation for delivery of at least one chemosensory receptor ligand tothe upper gastrointestinal tract and a second formulation for deliveryof at least one chemosensory receptor ligand to the lowergastrointestinal tract. Thus, a single composition can provide fordelivery of chemosensory receptor ligands to the upper and lowergastrointestinal tract. Additional non-limiting examples includecompositions having formulations for delivery of at least onechemosensory receptor ligand to the upper gastrointestinal tract andcompositions having formulations for delivery of at least onechemosensory receptor ligand to the lower gastrointestinal tract. Asdescribed herein, different combinations of chemosensory receptorligands can be formulated for treatment of specific conditions and fordelivery to specific locations in the intestinal tract.

Any of the delivery systems described herein may be used in combinationwith others to achieve multiple releases and/or specific releaseprofiles. In some embodiments, the active agent(s) is in a formulationthat achieves multiple releases in the gastrointestinal locationsfollowing administration. In certain embodiments, the active agent(s) isin a multiple release formulation that releases at an onset of about 10minutes, about 30 minutes, about 120 minutes, about 180 minutes, about240 minutes, or combinations thereof following administration. Incertain embodiments, the active agent(s) is in a multiple releaseformulation that releases at an onset of about 5 to about 45 minutes,about 105 to about 135 minutes, about 165 to about 195 minutes, about225 to about 255 minutes, or combinations thereof followingadministration. In other embodiments, the active agent(s) is in amultiple release formulation that releases in the duodenum, jejunum,ileum, lower intestine or combinations thereof following administration.In yet other embodiments, the active agent(s) is in a multiple releaseformulation that releases at an onset of about pH 5.5, about pH 6.0, atabout pH 6.5, about pH 7.0, or combinations thereof followingadministration. In yet other embodiments, the active agent(s) is in amultiple release formulation that releases in ranges at about pH 5.0 toabout pH 6.0, about pH 6.0 to about pH 7.0, about pH 7.0 to about pH8.0, or combinations thereof following administration. In yet otherembodiments, the active agent(s) is in a multiple release formulationthat releases a fraction or portion of the active agent(s) as animmediate release with the rest of the active agent(s) released by amodified manner described herein.

Excipients

Any of the compositions or formulations described herein include anycommonly used excipients in pharmaceutics and are selected on the basisof compatibility with the active agent(s) and release profile propertiesof the desired dosage form. Excipients include, but are not limited to,binders, fillers, flow aids/glidents, disintegrants, lubricants,stabilizers, surfactants, and the like. A summary of excipientsdescribed herein, may be found, for example in Remington: The Scienceand Practice of Pharmacy, Nineteeth Ed (Easton, Pa.: Mack PublishingCompany, 1995); Hoover, John E., Remington's Pharmaceutical Sciences,(Easton, Pa.: Mack Publishing Co 1975); Liberman, H. A. and Lachman, L.,Eds., Pharmaceutical Dosage Forms (New York, N.Y.: Marcel Decker 1980);and Pharmaceutical Dosage Forms and Drug Delivery Systems, Seventh Ed(Lippincott Williams & Wilkins 1999), herein incorporated by referencein their entirety.

Binders impart cohesive qualities and include, e.g., alginic acid andsalts thereof; cellulose derivatives such as carboxymethylcellulose,methylcellulose (e.g., Methocel®), hydroxypropylmethylcellulose,hydroxyethylcellulose, hydroxypropylcellulose (e.g., Klucel®),ethylcellulose (e.g., Ethocel®), and microcrystalline cellulose (e.g.,Avicel®); microcrystalline dextrose; amylose; magnesium aluminumsilicate; polysaccharide acids; bentonites; gelatin;polyvinylpyrrolidone/vinyl acetate copolymer; crospovidone; povidone;starch; pregelatinized starch; tragacanth, dextrin, a sugar, such assucrose (e.g., Dipac®), glucose, dextrose, molasses, mannitol, sorbitol,xylitol (e.g., Xylitab®), and lactose; a natural or synthetic gum suchas acacia, tragacanth, ghatti gum, mucilage of isapol husks,polyvinylpyrrolidone (e.g., Polyvidone® CL, Kollidon® CL, Polyplasdone®XL-10), larch arabogalactan, Veegum®, polyethylene glycol, waxes, sodiumalginate, and the like.

Disintegrants facilitate breakup or disintegration of oral solid dosageforms after administration. Examples of disintegrants include a starch,e.g., a natural starch such as corn starch or potato starch, apregelatinized starch such as National 1551 or Amijel®, or sodium starchglycolate such as Promogel® or Explotab®; a cellulose such as a woodproduct, methylcrystalline cellulose, e.g., Avicel®, Avicel® PH101,Avicel® PH102, Avicel® PH105, Elcema® P100, Emcocel®, Vivacel®, MingTia®, and Solka-Floc®, methylcellulose, croscarmellose, or across-linked cellulose, such as cross-linked sodiumcarboxymethylcellulose (Ac-Di-Sol®), cross-linkedcarboxymethylcellulose, or cross-linked croscarmellose; a cross-linkedstarch such as sodium starch glycolate; a cross-linked polymer such ascrospovidone; a cross-linked polyvinylpyrrolidone; alginate such asalginic acid or a salt of alginic acid such as sodium alginate; a claysuch as Veegum® HV (magnesium aluminum silicate); a gum such as agar,guar, locust bean, Karaya, pectin, or tragacanth; sodium starchglycolate; bentonite; a natural sponge; a resin such as acation-exchange resin; citrus pulp; sodium lauryl sulfate; sodium laurylsulfate in combination starch; and the like.

Lubricants are compounds which prevent, reduce or inhibit adhesion orfriction of materials. Exemplary lubricants include, e.g., stearic acid;calcium hydroxide; talc; sodium stearyl fumerate; a hydrocarbon such asmineral oil, hydrogenated castor oil or hydrogenated vegetable oil suchas hydrogenated soybean oil (Sterotex®); higher fatty acids and theiralkali-metal and alkaline earth metal salts, such as aluminum, calcium,magnesium, zinc; stearic acid, sodium stearates, magnesium stearates,glycerol, talc, waxes, Stearowet® boric acid, sodium benzoate, sodiumacetate, sodium chloride, leucine, a polyethylene glycol or amethoxypolyethylene glycol such as Carbowax™, ethylene oxide polymers,sodium oleate, glyceryl behenate (E.g. Compritol 888 Ato), glyceryldisterate (Precirol Ato 5), polyethylene glycol, magnesium or sodiumlauryl sulfate, colloidal silica such as Syloid™, Carb-O-Sil®,DL-leucine, a starch such as corn starch, silicone oil, a surfactant,and the like.

Flow-aids or glidants improve the flow characteristics of powdermixtures. Such compounds include, e.g., colloidal silicon dioxide suchas Cab-o-sil®; tribasic calcium phosphate, talc, corn starch,DL-leucine, sodium lauryl sulfate, magnesium stearate, calcium stearate,sodium stearate, kaolin, and micronized amorphous silicon dioxide(Syloid®) and the like.

Plasticizers aid in coating of oral solid dosage forms. Exemplaryplasticizers include, but are not limited to, triethyl citrate,triacetin (glyceryl triacetate), acetyl triethyl citrate, polyethyleneglycols (PEG 4000, PEG 6000, PEG 8000), Carbowax 400 (polyethyleneglycol 400), diethyl phthalate, diethyl sebacate, acetyltriethylcitrate,oleic acid, glyceralmonosterate, tributyl citrate, acetylatedmonoglycerides, glycerol, fatty acid esters, propylene glycol, anddibutyl phthalate and the like.

The aforementioned excipients are given as examples only and are notmeant to include all possible choices. Other suitable excipient classesinclude coloring agents, granulating agents, preservatives, anti-foamingagents, solubulizers and the like. Additionally, many excipients canhave more than one role or function, or can be classified in more thanone group; the classifications are descriptive only, and are notintended to limit any use of a particular excipient.

Methods for Evaluating Treatment

Hormonal Profiles

Administration of chemosensory receptor ligand compositions providedherein modulate hormone levels and/or concentrations including, but notlimited to, GLP-1, GLP-2, GIP, oxyntomodulin, PYY, cholecystokinin(CCK), glycentin, insulin, glucagon, ghrelin, amylin, insulin andinsulin C peptide. Sampling of hormones can be performed frequentlyduring the administration of ligands. Test animals and subjects can bestudied with and without systemic inhibition of dipeptidyl-peptidase IV(DPP-IV) to augment the circulating half-life of the relevant hormonesthat can be degraded by DPP-IV.

For glucose lowering, hormonal profiles suited for treating elevatedblood glucose are composed of, e.g., 1) GLP-1 with circulatingconcentrations over 1.5-fold or over 3-fold basal concentrations; 3) GIPwith circulating concentrations over 1.5-fold basal concentrations and3) PYY 3-36 circulating concentrations over 1.5-fold or over 2-foldbasal concentrations.

For weight loss, hormonal profiles suited for treating elevated bloodglucose are composed of, e.g., 1) PYY with circulating concentrationsover 3-fold basal concentrations; 2) Oxyntomodulin with circulatingconcentrations over 2-fold basal concentrations; 3) GPL-1 withcirculating concentrations over 3-fold basal concentrations; and 4) CCKwith circulating concentrations over 2-fold basal concentrations.

In some embodiments, administration of chemosensory receptor ligandcompositions as provided herein modulate circulating concentrations ofat least one, at least two, at least three, at least four, at leastfive, at least six, at least seven and at least eight hormones. Incertain embodiments, administration of chemosensory receptor ligandcompositions as provided herein increase circulating concentrations ofat least one, at least two, at least three, at least four, at leastfive, at least six, at least seven and at least eight hormones. In otherembodiments, administration of chemosensory receptor ligand compositionsas provided herein decrease circulating concentrations of at least one,at least two, at least three, at least four, at least five, at leastsix, at least seven and at least eight hormones. In some embodiments,administration of chemosensory receptor ligand compositions modulatesGLP-1. In some embodiments, administration of chemosensory receptorligand compositions modulates GLP-2. In some embodiments, administrationof chemosensory receptor ligand compositions modulates GIP. In someembodiments, administration of chemosensory receptor ligand compositionsmodulates oxyntomodulin. In some embodiments, administration ofchemosensory receptor ligand compositions modulates PYY. In someembodiments, administration of chemosensory receptor ligand compositionsmodulates CCK. In some embodiments, administration of chemosensoryreceptor ligand compositions modulates glycentin. In some embodiments,administration of chemosensory receptor ligand compositions modulatesinsulin. In some embodiments, administration of chemosensory receptorligand compositions modulates glucagon. In some embodiments,administration of chemosensory receptor ligand compositions modulates,ghrelin. In some embodiments, administration of chemosensory receptorligand compositions modulates amylin. In some embodiments,administration of chemosensory receptor ligand compositions modulatesinsulin. In some embodiments, administration of chemosensory receptorligand compositions modulates insulin C peptide.

Hormone Assays

In embodiments, the levels of hormones assayed in association with themethods of the invention, including, but not limited to, GLP-1, GLP-2,GIP, oxyntomodulin, PYY, CCK, glycentin, insulin, glucagon, ghrelin,amylin, insulin, insulin C peptide and/or combinations thereof aredetected according to standard methods described in the literature. Forexample, proteins can be measured by immunological assays, andtranscription products by nucleic acid amplification techniques.Functional assays described in the art can also be used as appropriate.In embodiments, samples assayed comprise cultured cells, patient cell ortissue samples, patient body fluids, e.g., blood or plasma, etc.

For example, immunofluorescence can be used to assay for GLP-1. Cellscan be grown on matrigel-coated cover slips to confluent monolayers in12-well plates at 37° C., fixed in 4% paraformaldehyde inphosphate-buffered saline (PBS) and incubated with primary antiserum(e.g., rabbit anti-alpha gustducin, 1:150; Santa Cruz Biotechnology, andrabbit anti-GLP-1, Phoenix) overnight at 4° C. followingpermeabilization with 0.4% Triton-X in PBS for 10 minutes and blockingfor 1 hour at room temperature. Following three washing steps withblocking buffer, the appropriate secondary antibody is applied(AlexaFluor 488 anti-rabbit immunoglobulin, 1:1000; Molecular Probes)for 1 hour at room temperature. After three washing steps, the cells canbe fixed in Vectashield medium and the immunofluorescence visualized.

GLP-1 RNA isolated from cells can be assayed using RT-PCR. RT-PCR RNAisolation from cells can be performed using standard methodology. TheRT-PCR reaction can be performed in a volume of 50 μl in a Peltierthermal cycler (PTC-225 DNA Engine Tetrad Cycler; MJ Research), usingpublished primer sequences (Integrated DNA Technologies). Reversetranscription can be performed at 50° C. for 30 minutes; after aninitial activation step at 95° C. for 15 minutes. PCR can be performedby denaturing at 94° C. for 1 minute, annealing at 55° C. for 1 minuteand extension at 72° C. for 1 minute for 40 cycles, followed by a finalextension step at 72° C. for 10 minutes. Negative controls can beincluded as appropriate, for example, by substituting water for theomitted reverse transcriptase or template. The control can be RNAisolated from, e.g., rat lingual epithelium. PCR products can beseparated in 2% agarose gel with ethidium bromide, and visualized underUV light.

Radioimmunoassay (RIA) for total GLP-1 in patient blood samples can beperformed as described in the art, e.g., by Laferrere, et al., 2007,“Incretin Levels and Effect are Markedly Enhanced 1 Month afterRoux-en-Y Gastric Bypass Surgery in Obese Patients with Type 2 Diabetes,Diabetes Care 30(7):1709-1716 (using commercially available materialsobtained from Phoenix Pharmaceutical, Belmont, Calif.). The authorsdescribe measuring the effect of GIP and GLP-1 on secretion of insulinby measuring the difference in insulin secretion (area under the curve,or AUC) in response to an oral glucose tolerance test and to anisoglycemic intravenous glucose test.

Measurement of plasma concentrations of GLP-1, GIP, glucagon, insulin, Cpeptide, pancreatic peptide, nonesterified fatty acids, glutamic aciddecarboxylase antibodies, and islet antigen antibodies, is described,e.g., by Toft-Nielsen, et al., 2001, “Determinants of the ImpairedSecretion of Glucagon-Like Peptide-1 in Type 2 Diabetic Patients,” J.Clin. End. Met. 86(8):3717-3723. The authors describe the use ofradioimmunoassay for GLP-1 to measure plasma concentrations of amidatedGLP-1-(7-36), using antibody code no. 89390. This assay measures the sumof GLP-1-(7-36) and its metabolite GLP-1-(9-36). The authors describemeasurement of GIP using C-terminally directed antibody code no. R65(RIA), that reacts 100% with a human GIP but not with 8-kDA GIP.

GLP-1 and PYY can be directly assayed in the supernatant from venouseffluents as described by, e.g., Claustre, et al. (1999, “Stimulatoryeffect of β-adrenergic agonists on ileal L cell secretion and modulationby α-adrenergic activation, J. Endocrin. 162:271-8). (See alsoPlaisancie' et al., 1994, “Regulation of glucagon-like peptide-1-(7-36)amide secretion by intestinal neurotransmitters and hormones in theisolated vascularly perfused rat colon,” Endocrinology 135:2398-2403 andPlaisancie′ et al., 1995, “Release of peptide YY by neurotransmittersand gut hormones in the isolated, vascularly perfused rat colon,”Scandinavian Journal of Gastroenterology 30:568-574.) In this method,the 199D anti-GLP-1 antibody is used at a 1:250 000 dilution. Thisantibody reacts 100% with GLP-1-(7-36) amide, 84% with GLP-1-(1-36)amide, and less than 0.1% with GLP-1-(1-37), GLP-1-(7-37), GLP-2, andglucagon. PYY is assayed with the A4D anti-porcine PYY antiserum at a1:800 000 dilution.

Methods for assaying GLP-1 and GIP are also described elsewhere in theart, e.g., by Jang, et al., PNAS, 2007.

PYY can also be assayed in blood using a radioimmunoassay as describedby, e.g., Weickert, et al., 2006, “Soy isoflavones increase preprandialpeptide YY (PYY), but have no effect on ghrelin and body weight inhealthy postmenopausal women” Journal of Negative Results inBioMedicine, 5:11. Blood is collected in ice-chilled EDTA tubes for theanalysis of glucose, ghrelin, and PYY. Following centrifugation at 1600g for 10 minutes at 4° C., aliquots were immediately frozen at −20° C.until assayed. All samples from individual subjects were measured in thesame assay. The authors described measuring immunoreactive total ghrelinwas measured by a commercially available radioimmunoassay (PhoenixPharmaceuticals, Mountain View, Calif., USA). (See also Weickert, etal., 2006, “Cereal fiber improves whole-body insulin sensitivity inoverweight and obese women,” Diabetes Care 29:775-780). Immunoreactivetotal human PYY is measured by a commercially available radioimmunoassay(LINCO Research, Missouri, USA), using ¹²⁵I-labeled bioactive PYY astracer and a PYY antiserum to determine the level of active PYY by thedouble antibody/PEG technique. The PYY antibody is raised in guinea pigsand recognizes both the PYY 1-36 and PYY 3-36 (active) forms of humanPYY.

SGLT-1, the intestinal sodium-dependent glucose transporter 1, is aprotein involved in providing glucose to the body. It has been reportedto be expressed in response to sugar in the lumen of the gut, through apathway involving T1R3 (Margolskee, et al., 2007 “T1R3 and gustducin ingut sense sugars to regulate expression of Na+-glucose cotransporter 1,”Proc Natl Acad Sci USA 104, 15075-15080″). Expression of SGLT-1 can bedetected as described, e.g., by Margolskee, et al., for example, usingquantitative PCR and Western Blotting methods known in the art.Measurement of glucose transport has been described in the literature,e.g., by Dyer, et al., 1997, Gut 41:56-9 and Dyer, et al., 2003, Eur. J.Biochem 270:3377-88. Measurement of glucose transport in brush bordermembrane vesicles can be made, e.g., by initiating D-glucose uptake bythe addition of 100 μl of incubation medium containing 100 mM NaSCN (orKSCN), 100 mM mannitol, 20 mM Hepes/Tris (pH 7.4), 0.1 mM MgSO4, 0.02%(wt/vol) NaN3, and 0.1 mM D-[U¹⁴C]glucose to BBMV (100 μg of protein).The reaction is stopped after 3 sec by addition of 1 ml of ice-cold stopbuffer, containing 150 mM KSCN, 20 mM Hepes/Tris (pH 7.4), 0.1 mM MgSO4,0.02% (wt/vol) NaN3, and 0.1 mM phlorizin. A 0.9-ml portion of thereaction mixture is removed and filtered under vacuum through a 0.22-μmpore cellulose acetate/nitrate filter (GSTF02500; Millipore, Bedford,Mass.). The filter is washed five times with 1 ml of stop buffer, andthe radioactivity retained on the filter is measured by liquidscintillation counting.

Evaluation of Treatment of Diabetes

The effect of a chemosensory receptor ligand treatment of the inventionon aspects of diabetic disease can be evaluated according to methodsknown in the art and common practiced by physicians treating diabeticsubjects.

Efficacy of treatment of diabetes/metabolic syndrome anddiabetes-associated conditions with the compositions and methodsdescribed herein can be assessed using assays and methodologies known inthe art. By way of example, quantitative assessment of renal functionand parameters of renal dysfunction are well known in the art. Examplesof assays for the determination of renal function/dysfunction includeserum creatinine level; creatinine clearance rate; cystatin C clearancerate, 24-hour urinary creatinine clearance, 24-hour urinary proteinsecretion; Glomerular filtration rate (GFR); urinary albumin creatinineratio (ACR); albumin excretion rate (AER); and renal biopsy.

Quantitative assessment of pancreatic function and parameters ofpancreatic dysfunction or insufficiency are also well known in the art.Examples of assays for the determination of pancreasfunction/dysfunction include evaluating pancreatic functions usingbiological and/or physiological parameters such as assessment of isletsof Langerhans size, growth and/or secreting activity, beta-cells size,growth and/or secreting activity, insulin secretion and circulatingblood levels, glucose blood levels, imaging of the pancreas, andpancreas biopsy, glucose uptake studies by oral glucose challenge,assessment of cytokine profiles, blood-gas analysis, extent ofblood-perfusion of tissues, and angiogenesis within tissues.

Additional assays for treatment of diabetes and diabetes-associatedconditions are known in the art and are contemplated herein.

Evaluation of Treatment of Obesity and Eating Disorders

In treatment of obesity it is desired that weight and/or fat is reducedin a subject. By reducing weight it is meant that the subject loses aportion of his/her total body weight over the course of treatment(whether the course of treatment be days, weeks, months or years).Alternatively, reducing weight can be defined as a decrease inproportion of fat mass to lean mass (in other words, the subject haslost fat mass, but maintained or gained lean mass, without necessarily acorresponding loss in total body weight). An effective amount of achemosensory receptor ligand treatment administered in this embodimentis an amount effective to reduce a subject's body weight over the courseof the treatment, or alternatively an amount effective to reduce thesubject's percentage of fat mass over the course of the treatment. Incertain embodiments, the subject's body weight is reduced, over thecourse of treatment, by at least about 1%, by at least about 5%, by atleast about 10%, by at least about 15%, or by at least about 20%.Alternatively, the subject's percentage of fat mass is reduced, over thecourse of treatment, by at least 1%, at least 5%, at least 10%, at least15%, at least 20%, or at least 25%.

Total body weight and fat content can be measured at the end of thedietary period. In rats, a frequently used method to determine totalbody fat is to surgically remove and weigh the retroperitoneal fat pad,a body of fat located in the retroperitoneum, the area between theposterior abdominal wall and the posterior parietal peritoneum. The padweight is considered to be directly related to percent body fat of theanimal. Since the relationship between body weight and body fat in ratsis linear, obese animals have a correspondingly higher percent of bodyfat and retroperitoneal fat pad weight.

In embodiments wherein methods of treating, reducing, or preventing foodcravings in a subject are provided, food cravings can be measured byusing a questionnaire, whether known in the art or created by the personstudying the food cravings. Such a questionnaire would preferably rankthe level of food cravings on a numerical scale, with the subjectmarking 0 if they have no food cravings, and marking (if on a scale of1-10) 10 if the subject has severe food cravings. The questionnairewould preferably also include questions as to what types of food thesubject is craving. Binge eating can be determined or measured using aquestionnaire and a Binge Eating Scale (BES). Binge eating severity canbe divided into three categories (mild, moderate, and severe) based onthe total BES score (calculated by summing the scores for eachindividual item). Accordingly, methods are provided for reducing the BESscore of a subject comprising administering to a subject in need thereofa chemosensory receptor ligand treatment in an amount effective toreduce the BES score of the subject. In some embodiments, administrationof a chemosensory receptor ligand treatment changes the BES category ofthe subject, for example, from severe to moderate, from severe to mild,or from moderate to mild.

Pre-Treatment Evaluation of Patient Hormonal Profile

In some embodiments, patients are pre-evaluated for expression ofmetabolic hormones using methods described herein. The therapy providedto the individual can thus be targeted to his or her specific needs. Inembodiments, a patient's hormonal profile is pre-evaluated and dependingon the changes that the physician desires to affect, a certainchemosensory receptor ligand/metabolite combination is administered. Theevaluation process can be repeated and the treatment adjustedaccordingly at any time during or following treatment.

Definitions

“Chemosensory receptor” as used herein includes, e.g., the G-proteincoupled receptors (GPCRs) that are expressed in the gastrointestinaltract of a subject. Chemosensory receptors include the taste receptorfamily and are further categorized according to their tastecharacteristics. They include sweet receptors, umami receptors (alsoknown as savory receptors), bitter receptors, fat receptors, bile acidreceptors, salty receptors, and sour receptors. A chemosensory receptorcan be any receptor associated with chemosensory sensation orchemosensory ligand triggered signal transduction, e.g., via tastereceptors or taste related receptors present in taste bud,gastrointestinal tract, etc.

Exemplary chemosensory receptors include T1R's (e.g., T1R1, T1R2, T1R3),T2R's, fat receptors, bile acid receptors, sweet receptors, saltyreceptors, variants, alleles, mutants, orthologs and chimeras thereofwhich specifically bind and/or respond to sweet, umami, bitter, bileacid, sour, salty, fat, or any other chemosensory related ligandsincluding activators, inhibitors and enhancers. Chemosensory receptorsalso include taste receptors expressed in humans or other mammals(interspecies homologs), e.g., cells associated with taste and/or partof gastrointestinal system including without any limitation, esophagus,stomach, intestine (small and large), colon, liver, biliary tract,pancreas, gallbladder, etc. Also, T1R polypeptides include chimericsequences derived from portions of a particular T1R polypeptide such asT1R1, T1R2 or T1R3 of different species or by combining portions ofdifferent T1Rs wherein such chimeric T1R sequences are combined toproduce a functional sweet or umami taste receptor. For example,chimeric T1Rs may comprise the extracellular region of one T1R, i.e.,T1R1 or T1R2 and the transmembrane region of another T1R, either T1R1 orT1R2.

Topologically, certain chemosensory GPCRs have an “N-terminal domain;”“extracellular domains,” a “transmembrane domain” comprising seventransmembrane regions, and corresponding cytoplasmic and extracellularloops, “cytoplasmic regions,” and a “C-terminal region” (see, e.g., Hoonet al., Cell 96:541-51 (1999); Buck et. al., Cell 65:175-87 (1991)).These regions can be structurally identified using methods known tothose of skill in the art, such as sequence analysis programs thatidentify hydrophobic and hydrophilic domains (see, e.g., Stryer,Biochemistry, (3rd ed. 1988); see also any of a number of Internet basedsequence analysis programs, such as those found atdot.imgen.bcm.tmc.edu). These regions are useful for making chimericproteins and for in vitro assays of the invention, e.g., ligand bindingassays.

“Extracellular domains” therefore refers to the domains of chemosensoryreceptors, e.g., T1R polypeptides that protrude from the cellularmembrane and are exposed to the extracellular face of the cell. Suchregions would include the “N-terminal domain” that is exposed to theextracellular face of the cell, as well as the extracellular loops ofthe transmembrane domain that are exposed to the extracellular face ofthe cell, i.e., the extracellular loops between transmembrane regions 2and 3, transmembrane regions 4 and 5, and transmembrane regions 6 and 7.The “N-terminal domain” starts at the N-terminus and extends to a regionclose to the start of the transmembrane region. These extracellularregions are useful for in vitro ligand binding assays, both soluble andsolid phase. In addition, transmembrane regions, described below, canalso be involved in ligand binding, either in combination with theextracellular region or alone, and are therefore also useful for invitro ligand binding assays.

“Transmembrane domain,” which comprises the seven transmembrane“regions,” refers to the domains of certain chemosensory receptors,e.g., T1R or T2R polypeptides that lie within the plasma membrane, andmay also include the corresponding cytoplasmic (intracellular) andextracellular loops, also referred to as transmembrane “regions.”

“Cytoplasmic domains” refers to the domains of chemosensory receptors,e.g., T1R or T2R proteins that face the inside of the cell, e.g., the“C-terminal domain” and the intracellular loops of the transmembranedomain, e.g., the intracellular loops between transmembrane regions 1and 2, transmembrane regions 3 and 4, and transmembrane regions 5 and 6.“C-terminal domain” refers to the region that spans from the end of thelast transmembrane region to the C-terminus of the protein, and which isnormally located within the cytoplasm.

The term “7-transmembrane receptor” includes polypeptides belonging to asuperfamily of transmembrane proteins that have seven regions that spanthe plasma membrane seven times (thus, the seven regions are called“transmembrane” or “TM” domains TM I to TM VII).

The terms “gastrointestinal tract” “and “gut,” as used herein, refer tothe stomach and intestine. The “small” or “upper” intestine includes theduodenum, jejunum and ileum and the “large” or “lower” intestineincludes the caecum, colon and rectum.

“Activity,” or “functional effects” in the context of the disclosedligands and assays for testing compounds that modulate a chemosensoryreceptor, e.g., enhance a chemosensory receptor family member mediatedsignal transduction such as sweet, umami, bitter, fat, bile acid, souror salty receptor functional effects or activity, includes thedetermination of any parameter that is indirectly or directly under theinfluence of the particular chemosensory receptor. It includes, withoutany limitation, ligand binding, changes in ion flux, membrane potential,current flow, transcription, G protein binding, GPCR phosphorylation ordephosphorylation, signal transduction, receptor-ligand interactions,second messenger concentrations (e.g., cAMP, cGMP, IP3, or intracellularCa²⁺), in vitro, in vivo, and ex vivo and also includes otherphysiologic effects such as increases or decreases of neurotransmitteror hormone release and the measurement of the downstream physiologicaleffects of such release.

The term “determining the functional effect” or receptor “activity”means assays for a compound that increases or decreases a parameter thatis indirectly or directly under the influence of a chemosensoryreceptor, e.g., functional, physical and chemical effects. Suchparameters also include secretion of hormones such as GIP, GLP-1, GLP-2,oxyntomodulin, insulin, glucagon, insulin peptide C, peptide YY, andCCK. Such functional effects can be measured by any means known to thoseskilled in the art, e.g., changes in spectroscopic characteristics(e.g., fluorescence, absorbance, refractive index), hydrodynamic (e.g.,shape), chromatographic, or solubility properties, patch clamping,voltage-sensitive dyes, whole cell currents, radioisotope efflux,inducible markers, oocyte chemosensory receptor, e.g., T1R geneexpression; tissue culture cell chemosensory receptor, e.g., T1Rexpression; transcriptional activation of chemosensory receptor, e.g.,T1R genes; ligand binding assays; voltage, membrane potential andconductance changes; ion flux assays; changes in intracellular secondmessengers such as cAMP, cGMP, and inositol triphosphate (IP3); changesin intracellular calcium levels; neurotransmitter release, and the like.Also included are assays to determine increases or decreases in hormoneor neurotransmitter secretion and/or activity. Changes in hormone orneurotransmitter secretion and/or activity can also be determinedindirectly by the physiological effects caused by changes in thesecretion of hormone or neurotransmitter. Functional and physicalparameters that can be used to determine the functional effect orreceptor activity include, but is not limited to, appetite suppressionand weight loss.

Chemosensory receptor ligands include metabolized chemosensory receptorligands that can be metabolized as an energy source, e.g. food ormetabolites, as well as nonmetabolized chemosensory receptor ligandsthat are not metabolized as an energy source, e.g. tastants. The termnonmetabolized chemosensory receptor ligands, as used herein, includeschemosensory receptor ligands that are metabolized to a small degree butare not metabolized substantially. That is, nonmetabolized chemosensoryreceptor ligand includes ligands that have insignificant caloric value.Chemosensory receptor ligands include agonists, antagonists, modifiers,and enhancers as well as other compounds that modulate chemosensoryreceptors. Many chemosensory receptor ligands are known in the art andhave been reported in the literature.

“Tastants” as used herein refers to any ligand that induces a flavor ortaste in a subject, including sweet, sour, salty, bitter, umami andothers. Tastants are also generally nonmetabolized in the sense thatthey have no significant caloric value.

“Metabolites” as used herein are metabolized chemosensory receptorligands such as, for example, glucose, glutamate salts, fatty acids andbile acids. In certain aspects, metabolites can be derived from a foodsource. Metabolites can be administered as part of a chemosensoryreceptor ligand composition or separately.

Antagonists/inhibitors are compounds that, e.g., bind to, partially ortotally block stimulation, decrease, prevent, delay activation,inactivate, desensitize, or down-regulate chemosensory receptor and/ortaste transduction. Agonists/activators are compounds that, e.g., bindto, stimulate, increase, open, activate, facilitate, enhance activation,sensitize, or up regulate chemosensory receptor signal transduction.

Modifiers include compounds that, e.g., alter, directly or indirectly,the activity of a receptor or the interaction of a receptor with itsligands, e.g., receptor ligands, and optionally bind to or interact withactivators or inhibitors; G Proteins; kinases (e.g., homologs ofrhodopsin kinase and beta adrenergic receptor kinases that are involvedin deactivation and desensitization of a receptor); and arresting, whichalso deactivate and desensitize receptors. Modifiers include geneticallymodified versions of chemosensory receptors, e.g., T1R family members,e.g., with altered activity, as well as naturally occurring andsynthetic ligands, antagonists, agonists, small chemical molecules andthe like. In the present invention this includes, without anylimitation, sweet receptor ligands, umami receptor ligands, bitterreceptor ligands, fatty acid ligands, bile receptor ligands, (agonistsor antagonists). Modifiers also include compounds that allostericallybind to a receptor and change receptor activity. Modifiers also includeenhancers. Depending on the structure, functional and activityproperties, modifiers can enhance, potentiate, induce and/or block thephysiological activity other chemosensory receptor ligands.

Enhancers as used herein are a type of modifier and refer tochemosensory receptor ligands that enhance, potentiate or multiply theeffect of another chemosensory receptor ligand. For example, a sweetreceptor enhancer can increase or multiply the sweetness of achemosensory receptor ligand composition, when used in combination witha sweet receptor ligand (e.g., a sweetener, such as sucrose, fructose,glucose, saccharine, aspartame, sucralose, etc.). While a sweet receptorenhancer may or may not have sweet properties at some combinations whenused in the absence of a sweet receptor ligand, sweet receptorenhancement occurs when the sweet receptor enhancer is used incombination with another sweet receptor ligand with the result that theresulting sweetness perceived in a subject is greater than the additiveeffects attributable to the sweet receptor enhancer's own sweetproperties (if any), plus the sweetness attributable to the presence ofthe sweet receptor ligand.

“Treating” or “treatment” of any condition, disease or disorder refers,in some embodiments, to ameliorating the disease or disorder (i.e.,arresting or reducing the development of the disease or at least one ofthe clinical symptoms thereof). In other embodiments “treating” or“treatment” refers to ameliorating at least one physical parameter,which may not be discernible by the patient. In yet other embodiments,“treating” or “treatment” refers to inhibiting the disease or disorder,either physically, (e.g., stabilization of a discernible symptom),physiologically, (e.g., stabilization of a physical parameter) or both.In yet other embodiments, “treating” or “treatment” refers preventing orto delaying the onset of the disease or disorder.

“Therapeutically effective amount” or “effective amount” means theamount of a composition, compound, therapy, or course of treatment that,when administered to a patient for treating a disease, is sufficient toeffect such treatment for the disease. The “therapeutically effectiveamount” will vary depending on the composition, the compound, thetherapy, the course of treatment, the disease and its severity and theage, weight, etc., of the patient to be treated.

EXAMPLES Example 1 Example 1a Upper GI Administration of OneChemosensory Receptor Ligand in Diabetic Rats

Numerous established and accepted diabetic rat models exist for theassessment of therapies for the treatment of diabetes. A singlechemosensory receptor ligand (e.g., sweet) can be assayed for thetreatment of diabetes in this established diabetic rat model as detailedin the example below.

Diabetic rats and Wistar rats are selected for administration of thechemosensory receptor ligand (e.g., sucralose) for the treatment ofdiabetes. Animals are grouped according to dosage, and increasingdosages (range of 0.01-100 mg/kg) are utilized. Chemosensory receptorligands are instilled into the animals via silastic tubing inserted intothe duodenum through the mouths of the lightly anesthetized animals.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test animals to prevent degradation of the targethormones by endogenous peptidases. DPP IV inhibition is accomplished viaco-administration of sitagliptin (10 mg/kg) at least one hour prior tochemosensory receptor ligand instillation.

Blood samples are collected via cannulation of the tail vein, andsamples are withdrawn at baseline, 15, 30, 60 and 120 minutespost-instillation. Blood samples are collected in collection tubescontaining standard cocktails of peptidase inhibitors and preservatives,and samples are stored at −25° C. until assayed. Blood samples areassayed for the presence of hormones related to insulin regulation,including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY, Insulin, Glucagon,C-peptide, Ghrelin, and GLP-2. Assays for the hormones are performedusing standard ELISA methodologies. Results are analyzed for efficacy ofchemosensory receptor ligand administration for the treatment ofdiabetic rats. Metabolites and other analyte concentrations, includingglucose, free fatty acids, triglycerides, calcium, potassium, sodium,magnesium, phosphate, are also assessed. Circulating concentrations ofat least one of the measured GLP-1, GLP-2, GIP, oxyntomodulin, PeptideYY, CCK, glucagon and insulinogenic index are expected to increase.

The experimental protocol is performed for five chemosensory receptorligand types (Sweet, Umami, Fat, Bitter, and Bile Acid) according theabove protocol. Exemplary ligands and respective dose ranges are asfollows:

Sucralose: 0.01-100 mg/kg

MSG: 0.01-100 mg/kg

Fatty acid emulsion: 10% solution at 0.5-10 ml/min over ranges of 10sec.-to 5 min.

Quinine: 0.01-100 mg/kg

Chenodeoxycholic acid (CDC): 1-50 mMol solution at 1-10 ml/min over arange of 10 sec.-5 min.

Example 1b

Alternatively, the chemosensory receptor ligand, if not metabolized, isadministered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligand may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 1c

Alternatively, the experimental protocol above is performed withindustry standard Diet Induced Obese rats and applicable controls(healthy rats). Parameters unique to the obesity systems are modifiedbased on known standard assay conditions. Samples are collected andhormone assays performed as described above.

Example 2 Example 2a Lower GI Administration of One ChemosensoryReceptor Ligand in Diabetic Rats

Numerous established and accepted diabetic rat models exist for theassessment of therapies for the treatment of diabetes. A singlechemosensory receptor ligand (e.g., sweet) can be assayed for thetreatment of diabetes in this established diabetic rat model as detailedin the example below.

Diabetic rats and Wistar rats are selected for administration of thechemosensory receptor ligand (e.g., sucralose) for the treatment ofdiabetes. Animals are grouped according to dosage, and increasingdosages (sucralose range of 0.01-100 mg/kg) are utilized. Chemosensoryreceptor ligands are instilled into the animals via silastic tubinginserted midway up the descending colon through the rectum of thelightly anesthetized animals.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test animals to prevent degradation of the targethormones by endogenous peptidases. DPP IV inhibition is accomplished viaco-administration of sitagliptin (10 mg/kg) at least one hour prior tochemosensory receptor ligand instillation.

Blood samples are collected via cannulation of the tail vein, andsamples are withdrawn at baseline, 15, 30, 60 and 120 minutespost-instillation. Blood samples are collected in collection tubescontaining standard cocktails of peptidase inhibitors and preservatives,and samples are stored at −25° C. until assayed. Blood samples areassayed for the presence of hormones related to insulin regulation,including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY, Insulin, Glucagon,C-peptide, Ghrelin, and GLP-2. Assays for the hormones are performedusing standard ELISA methodologies. Results are analyzed for efficacy ofchemosensory receptor ligand administration for the treatment ofdiabetic rats. Metabolites and other analyte concentrations, includingglucose, free fatty acids, triglycerides, calcium, potassium, sodium,magnesium, phosphate, are also assessed. Circulating concentrations ofat least one of the measured GLP-1, GLP-2, GIP, oxyntomodulin, PeptideYY, CCK, glucagon and insulinogenic index are expected to increase.

The experimental protocol is performed for five chemosensory receptorligand types (Sweet, Umami, Fat, Bitter, and Bile Acid) according theabove protocol. Exemplary ligands and respective dose ranges are asfollows:

Sucralose: 0.01-100 mg/kg

MSG: 0.01-100 mg/kg

Fatty acid emulsion: 10% solution at 0.5-10 ml/min over ranges of 10sec.-to 5 min.

Quinine: 0.01-100 mg/kg

Chenodeoxycholic acid (CDC): 1-50 mMol solution at 1-10 ml/min over arange of 10 sec.-5 min.

Example 2b

Alternatively, the chemosensory receptor ligand, if not metabolized, isadministered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligand may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 2c

Alternatively, the experimental protocol above is performed withindustry standard Diet Induced Obese rats and applicable controls(healthy rats). Parameters unique to the obesity systems are modifiedbased on known standard assay conditions. Samples are collected andhormone assays performed as described above.

Example 3 Example 3a Upper GI Administration of Two ChemosensoryReceptor Ligands in Diabetic Rats

Numerous established and accepted diabetic rat models exist for theassessment of therapies for the treatment of diabetes. Two chemosensoryreceptor ligands can be assayed for the treatment of diabetes in thisestablished diabetic rat model as detailed in the example below.

Diabetic rats and Wistar rats are selected for administration of thechemosensory receptor ligands for the treatment of diabetes andappropriate control perturbations (one ligand alone, saline alone).Animals are grouped according to dosage, and increasing dosages areutilized (increasing dose of one ligand with fixed doses of anotherligand). Chemosensory receptor ligands are instilled into the animalsvia silastic tubing inserted into the duodenum through the mouths of thelightly anesthetized animals.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test animals to prevent degradation of the targethormones by endogenous peptidases. DPP IV inhibition is accomplished viaco-administration of sitagliptin (10 mg/kg) at least one hour prior tochemosensory receptor ligand instillation.

Blood samples are collected via cannulation of the tail vein, andsamples are withdrawn at baseline, 15, 30, 60 and 120 minutespost-instillation. Blood samples are collected in collection tubescontaining standard cocktails of peptidase inhibitors and preservatives,and samples are stored at −25° C. until assayed. Blood samples areassayed for the presence of hormones related to insulin regulation,including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY, Insulin, Glucagon,C-peptide, Ghrelin, and GLP-2. Assays for the hormones are performedusing standard ELISA methodologies. Results are analyzed for efficacy ofchemosensory receptor ligand administration for the treatment ofdiabetic rats. Metabolites and other analyte concentrations, includingglucose, free fatty acids, triglycerides, calcium, potassium, sodium,magnesium, phosphate, are also assessed. Circulating concentrations ofat least one of the measured GLP-1, GLP-2, GIP, oxyntomodulin, PeptideYY, CCK, glucagon and insulinogenic index are expected to increase.

The experimental protocol is performed for combinations of twochemosensory receptor ligands including chemosensory receptor ligandtypes Sweet, Umami, Fat, Bitter, and Bile Acid according the aboveprotocol. Exemplary ligands and respective dose ranges are as follows:

Sucralose: 0.01-100 mg/kg

MSG: 0.01-100 mg/kg

Fatty acid emulsion: 10% solution at 0.5-10 ml/min over ranges of 10sec.-to 5 min.

Quinine: 0.01-100 mg/kg

Chenodeoxycholic acid (CDC): 1-50 mMol solution at 1-10 ml/min over arange of 10 sec.-5 min.

Example 3b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligands may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 3c

Alternatively, the experimental protocol above is performed withindustry standard Diet Induced Obese rats and applicable controls(healthy rats). Parameters unique to the obesity systems are modifiedbased on known standard assay conditions. Samples are collected andhormone assays performed as described above.

Example 4 Example 4a Lower GI Administration of Two ChemosensoryReceptor Ligand in Diabetic Rats

Numerous established and accepted diabetic rat models exist for theassessment of therapies for the treatment of diabetes. Two chemosensoryreceptor ligands can be assayed for the treatment of diabetes in thisestablished diabetic rat model as detailed in the example below.

Diabetic rats and Wistar rats are selected for administration of twochemosensory receptor ligands for the treatment of diabetes. Animals aregrouped according to dosage, and increasing dosages. Chemosensoryreceptor ligands are instilled into the animals via silastic tubinginserted midway up the descending colon through the rectum of thelightly anesthetized animals.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test animals to prevent degradation of the targethormones by endogenous peptidases. DPP IV inhibition is accomplished viaco-administration of sitagliptin (10 mg/kg) at least one hour prior tochemosensory receptor ligand instillation.

Blood samples are collected via cannulation of the tail vein, andsamples are withdrawn at baseline, 15, 30, 60 and 120 minutespost-instillation. Blood samples are collected in collection tubescontaining standard cocktails of peptidase inhibitors and preservatives,and samples are stored at −25° C. until assayed. Blood samples areassayed for the presence of hormones related to insulin regulation,including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY, Insulin, Glucagon,C-peptide, Ghrelin, and GLP-2. Assays for the hormones are performedusing standard ELISA methodologies. Results are analyzed for efficacy ofchemosensory receptor ligand administration for the treatment ofdiabetic rats. Metabolites and other analyte concentrations, includingglucose, free fatty acids, triglycerides, calcium, potassium, sodium,magnesium, phosphate, are also assessed. Circulating concentrations ofat least one of the measured GLP-1, GLP-2, GIP, oxyntomodulin, PeptideYY, CCK, glucagon and insulinogenic index are expected to increase.

The experimental protocol is performed for combinations of twochemosensory receptor ligands including chemosensory receptor ligandtypes Sweet, Umami, Fat, Bitter, and Bile Acid according the aboveprotocol. Exemplary ligands and respective dose ranges are as follows:

Sucralose: 0.01-100 mg/kg

MSG: 0.01-100 mg/kg

Fatty acid emulsion: 10% solution at 0.5-10 ml/min over ranges of 10sec.-to 5 min.

Quinine: 0.01-100 mg/kg

Chenodeoxycholic acid (CDC): 1-50 mMol solution at 1-10 ml/min over arange of 10 sec.-5 min.

Example 4b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligands may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 4c

Alternatively, the experimental protocol above is performed withindustry standard Diet Induced Obese rats and applicable controls(healthy rats). Parameters unique to the obesity systems are modifiedbased on known standard assay conditions. Samples are collected andhormone assays performed as described above.

Example 5 Example 5a Upper GI Administration of Three ChemosensoryReceptor Ligands (Sweet, Umami, and Fat) in Diabetic Rats

Numerous established and accepted diabetic rat models exist for theassessment of therapies for the treatment of diabetes. Threechemosensory receptor ligands (Sweet, umami, and fat) can be assayed forthe treatment of diabetes (increased efficacy over single chemosensoryreceptor ligands, synergistic effects, etc.) in this establisheddiabetic rat model as detailed in the example below.

Diabetic rats and Wistar rats are selected for administration of theligands sucralose, monosodium glutamate (MSG), and a fatty acid emulsionfor the treatment of diabetes. Animals are grouped according to dosage,and increasing dosages (sucralose range of 0.01−100 mg/kg; MSG range of0.01-100 mg/.kg; fatty acid emulsion (e.g., Intralipid®) of 10% solutionat 0.5-10 ml/min over ranges of 10 sec.-to 5 min.) are utilized.Chemosensory receptor ligands are instilled into the animals viasilastic tubing inserted into the duodenum through the mouths of thelightly anesthetized animals.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test animals to prevent degradation of the targethormones by endogenous peptidases. DPP IV inhibition is accomplished viaco-administration of sitagliptin (10 mg/kg) at least one hour prior tochemosensory receptor ligand instillation.

Blood samples are collected via cannulation of the tail vein, andsamples are withdrawn at baseline, 15, 30, 60 and 120 minutespost-instillation. Blood samples are collected in collection tubescontaining standard cocktails of peptidase inhibitors and preservatives,and samples are stored at −25° C. until assayed. Blood samples areassayed for the presence of hormones related to insulin regulation,including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY, Insulin, Glucagon,C-peptide, Ghrelin, and GLP-2. Assays for the hormones are performedusing standard ELISA methodologies. Results are analyzed for efficacy ofchemosensory receptor ligand administration for the treatment ofdiabetic rats. Metabolites and other analyte concentrations, includingglucose, free fatty acids, triglycerides, calcium, potassium, sodium,magnesium, phosphate, are also assessed. Circulating concentrations ofat least one of the measured GLP-1, GLP-2, GIP, oxyntomodulin, PeptideYY, CCK, glucagon and insulinogenic index are expected to increase.

Example 5b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligands may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 5c

Alternatively, the experimental protocol above is performed withindustry standard Diet Induced Obese rats and applicable controls(healthy rats). Parameters unique to the obesity systems are modifiedbased on known standard assay conditions. Samples are collected andhormone assays performed as described above.

Example 6 Example 6a Lower GI Administration of Three ChemosensoryReceptor Ligands (Sweet, Umami, and Fat) in Diabetic Rats

Numerous established and accepted diabetic rat models exist for theassessment of therapies for the treatment of diabetes. Threechemosensory receptor ligands (Sweet, umami, and fat) can be assayed forthe treatment of diabetes (increased efficacy over single chemosensoryreceptor ligands, synergistic effects, etc.) in this establisheddiabetic rat model as detailed in the example below.

Diabetic rats and Wistar rats are selected for administration of thechemosensory receptor ligands sucralose, monosodium glutamate (MSG), anda fatty acid emulsion. Animals are grouped according to dosage, andincreasing dosages (sucralose range of 0.01-100 mg/kg; MSG range of0.01-100 mg/kg; fatty acid emulsion (e.g., Intralipid®) of 10% solutionat 0.5-10 ml/min over ranges of 10 sec.-to 5 min.) are utilized.Chemosensory receptor ligands are instilled into the animals viasilastic tubing inserted midway up the descending colon through therectum of the lightly anesthetized animals.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all of the test animals to prevent degradation of the targethormones by endogenous peptidases. DPP IV inhibition is accomplished viaco-administration of sitagliptin (10 mg/kg) at least one hour prior tochemosensory receptor ligand instillation.

Blood samples are collected via cannulation of the tail vein, andsamples are withdrawn at baseline, 15, 30, 60 and 120 minutespost-instillation. Blood samples are collected in collection tubescontaining standard cocktails of peptidase inhibitors and preservatives,and samples are stored at −25° C. until assayed. Blood samples areassayed for the presence of hormones related to insulin regulation,including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY, Insulin, Glucagon,C-peptide, Ghrelin, and GLP-2. Assays for the hormones are performedusing standard ELISA methodologies. Results are analyzed for efficacy ofchemosensory receptor ligand administration for the treatment ofdiabetic rats. Metabolites and other analyte concentrations, includingglucose, free fatty acids, triglycerides, calcium, potassium, sodium,magnesium, phosphate, are also assessed. Circulating concentrations ofat least one of the measured GLP-1, GLP-2, GIP, oxyntomodulin, PeptideYY, CCK, glucagon and insulinogenic index are expected to increase.

Example 6b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligands may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 6c

Alternatively, the experimental protocol above is performed withindustry standard Diet Induced Obese rats and applicable controls(healthy rats). Parameters unique to the obesity systems are modifiedbased on known standard assay conditions. Samples are collected andhormone assays performed as described above.

Example 7 Example 7a Upper GI Administration of Three ChemosensoryReceptor Ligands (Sweet, Umami, and Bitter) in Diabetic Rats

Numerous established and accepted diabetic rat models exist for theassessment of therapies for the treatment of diabetes. Threechemosensory receptor ligands (Sweet, umami, and bitter) can be assayedfor the treatment of diabetes (increased efficacy over singlechemosensory receptor ligands, synergistic effects, etc.) in thisestablished diabetic rat model as detailed in the example below.

Diabetic rats and Wistar rats are selected for administration of theligands sucralose, monosodium glutamate (MSG), and Quinine for thetreatment of diabetes. Animals are grouped according to dosage, andincreasing dosages (sucralose range of 0.01-100 mg/kg; MSG range of0.01-100 mg/.kg; Quinine range of 0.01-100 mg/kg) are utilized.Chemosensory receptor ligands are instilled into the animals viasilastic tubing inserted into the duodenum through the mouths of thelightly anesthetized animals.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test animals to prevent degradation of the targethormones by endogenous peptidases. DPP IV inhibition is accomplished viaco-administration of sitagliptin (10 mg/kg) at least one hour prior tochemosensory receptor ligand instillation.

Blood samples are collected via cannulation of the tail vein, andsamples are withdrawn at baseline, 15, 30, 60 and 120 minutespost-instillation. Blood samples are collected in collection tubescontaining standard cocktails of peptidase inhibitors and preservatives,and samples are stored at −25° C. until assayed. Blood samples areassayed for the presence of hormones related to insulin regulation,including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY, Insulin, Glucagon,C-peptide, Ghrelin, and GLP-2. Assays for the hormones are performedusing standard ELISA methodologies. Results are analyzed for efficacy ofchemosensory receptor ligand administration for the treatment ofdiabetic rats. Metabolites and other analyte concentrations, includingglucose, free fatty acids, triglycerides, calcium, potassium, sodium,magnesium, phosphate, are also assessed. Circulating concentrations ofat least one of the measured GLP-1, GLP-2, GIP, oxyntomodulin, PeptideYY, CCK, glucagon and insulinogenic index are expected to increase.

Example 7b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligands may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 7c

Alternatively, the experimental protocol above is performed withindustry standard Diet Induced Obese rats and applicable controls(healthy rats). Parameters unique to the obesity systems are modifiedbased on known standard assay conditions. Samples are collected andhormone assays performed as described above.

Example 8 Example 8a Lower GI Administration of Three ChemosensoryReceptor Ligands (Sweet, Umami, and Bitter) in Diabetic Rats

Numerous established and accepted diabetic rat models exist for theassessment of therapies for the treatment of diabetes. Threechemosensory receptor ligands (Sweet, umami, and bitter) can be assayedfor the treatment of diabetes (increased efficacy over singlechemosensory receptor ligands, synergistic effects, etc.) in thisestablished diabetic rat model as detailed in the example below.

Diabetic rats and Wistar rats are selected for administration of thechemosensory receptor ligands sucralose, monosodium glutamate (MSG), andQuinine for the treatment of diabetes. Animals are grouped according todosage, and increasing dosages (sucralose range of 0.01-100 mg/kg; MSGrange of 0.01-100 mg/kg; Quinine range of 0.01-100 mg/kg) are utilized.Chemosensory receptor ligands are instilled into the animals viasilastic tubing inserted midway up the descending colon through therectum of the lightly anesthetized animals.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all of the test animals to prevent degradation of the targethormones by endogenous peptidases. DPP IV inhibition is accomplished viaco-administration of sitagliptin (10 mg/kg) at least one hour prior tochemosensory receptor ligand instillation.

Blood samples are collected via cannulation of the tail vein, andsamples are withdrawn at baseline, 15, 30, 60 and 120 minutespost-instillation. Blood samples are collected in collection tubescontaining standard cocktails of peptidase inhibitors and preservatives,and samples are stored at −25° C. until assayed. Blood samples areassayed for the presence of hormones related to insulin regulation,including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY, Insulin, Glucagon,C-peptide, Ghrelin, and GLP-2. Assays for the hormones are performedusing standard ELISA methodologies. Results are analyzed for efficacy ofchemosensory receptor ligand administration for the treatment ofdiabetic rats. Metabolites and other analyte concentrations, includingglucose, free fatty acids, triglycerides, calcium, potassium, sodium,magnesium, phosphate, are also assessed. Circulating concentrations ofat least one of the measured GLP-1, GLP-2, GIP, oxyntomodulin, PeptideYY, CCK, glucagon and insulinogenic index are expected to increase.

Example 8b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligands may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 8c

Alternatively, the experimental protocol above is performed withindustry standard Diet Induced Obese rats and applicable controls(healthy rats). Parameters unique to the obesity systems are modifiedbased on known standard assay conditions. Samples are collected andhormone assays performed as described above.

Example 9 Example 9a Upper GI Administration of Three ChemosensoryReceptor Ligands (Sweet, Fat, and Bitter) in Diabetic Rats

Numerous established and accepted diabetic rat models exist for theassessment of therapies for the treatment of diabetes. Threechemosensory receptor ligands (Sweet, fat, and bitter) can be assayedfor the treatment of diabetes (increased efficacy over singlechemosensory receptor ligands, synergistic effects, etc.) in thisestablished diabetic rat model as detailed in the example below.

Diabetic rats and Wistar rats are selected for administration of theligands sucralose, fatty acid emulsion, and Quinine for the treatment ofdiabetes. Quinine and fat or fatty acid ligands do not require a cognatemetabolite. Animals are grouped according to dosage, and increasingdosages (sucralose range of 0.01-100 mg/kg; fatty acid emulsion (e.g.,Intralipid®) of 10% solution at 0.5-10 ml/min over ranges of 10 sec.-to5 min; Quinine range of 0.01-100 mg/.kg) are utilized. Chemosensoryreceptor ligands are instilled into the animals via silastic tubinginserted into the duodenum through the mouths of the lightlyanesthetized animals.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test animals to prevent degradation of the targethormones by endogenous peptidases. DPP IV inhibition is accomplished viaco-administration of sitagliptin (10 mg/kg) at least one hour prior tochemosensory receptor ligand instillation.

Blood samples are collected via cannulation of the tail vein, andsamples are withdrawn at baseline, 15, 30, 60 and 120 minutespost-instillation. Blood samples are collected in collection tubescontaining standard cocktails of peptidase inhibitors and preservatives,and samples are stored at −25° C. until assayed. Blood samples areassayed for the presence of hormones related to insulin regulation,including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY, Insulin, Glucagon,C-peptide, Ghrelin, and GLP-2. Assays for the hormones are performedusing standard ELISA methodologies. Results are analyzed for efficacy ofchemosensory receptor ligand administration for the treatment ofdiabetic rats. Metabolites and other analyte concentrations, includingglucose, free fatty acids, triglycerides, calcium, potassium, sodium,magnesium, phosphate, are also assessed. Circulating concentrations ofat least one of the measured GLP-1, GLP-2, GIP, oxyntomodulin, PeptideYY, CCK, glucagon and insulinogenic index are expected to increase.

Example 9b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligands may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 9c

Alternatively, the experimental protocol above is performed withindustry standard Diet Induced Obese rats and applicable controls(healthy rats). Parameters unique to the obesity systems are modifiedbased on known standard assay conditions. Samples are collected andhormone assays performed as described above.

Example 10 Example 10a Lower GI Administration of Three ChemosensoryReceptor Ligands (Sweet, Fat, and Bitter) in Diabetic Rats

Numerous established and accepted diabetic rat models exist for theassessment of therapies for the treatment of diabetes. Threechemosensory receptor ligands (Sweet, fat, and bitter) can be assayedfor the treatment of diabetes (increased efficacy over singlechemosensory receptor ligands, synergistic effects, etc.) in thisestablished diabetic rat model as detailed in the example below.

Diabetic rats and Wistar rats are selected for administration of thechemosensory receptor ligands sucralose, fatty acid emulsion, andQuinine for the treatment of diabetes. Animals are grouped according todosage, and increasing dosages (sucralose range of 0.01-100 mg/kg; fattyacid emulsion (e.g., Intralipid®) of 10% solution at 0.5-10 ml/min overranges of 10 sec.-to 5 min; Quinine range of 0.01-100 mg/kg) areutilized. Chemosensory receptor ligands are instilled into the animalsvia silastic tubing inserted midway up the descending colon through therectum of the lightly anesthetized animals.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all of the test animals to prevent degradation of the targethormones by endogenous peptidases. DPP IV inhibition is accomplished viaco-administration of sitagliptin (10 mg/kg) at least one hour prior tochemosensory receptor ligand instillation.

Blood samples are collected via cannulation of the tail vein, andsamples are withdrawn at baseline, 15, 30, 60 and 120 minutespost-instillation. Blood samples are collected in collection tubescontaining standard cocktails of peptidase inhibitors and preservatives,and samples are stored at −25° C. until assayed. Blood samples areassayed for the presence of hormones related to insulin regulation,including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY, Insulin, Glucagon,C-peptide, Ghrelin, and GLP-2. Assays for the hormones are performedusing standard ELISA methodologies. Results are analyzed for efficacy ofchemosensory receptor ligand administration for the treatment ofdiabetic rats. Metabolites and other analyte concentrations, includingglucose, free fatty acids, triglycerides, calcium, potassium, sodium,magnesium, phosphate, are also assessed. Circulating concentrations ofat least one of the measured GLP-1, GLP-2, GIP, oxyntomodulin, PeptideYY, CCK, glucagon and insulinogenic index are expected to increase.

Example 10b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligands may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 10c

Alternatively, the experimental protocol above is performed withindustry standard Diet Induced Obese rats and applicable controls(healthy rats). Parameters unique to the obesity systems are modifiedbased on known standard assay conditions. Samples are collected andhormone assays performed as described above.

Example 11 Example 11a Upper GI Administration of Four ChemosensoryReceptor Ligands (Sweet, Umami, Fat, and Bitter) in Diabetic Rats

Numerous established and accepted diabetic rat models exist for theassessment of therapies for the treatment of diabetes. Four chemosensoryreceptor ligands (Sweet, MSG, fat, and bitter) can be assayed for thetreatment of diabetes (increased efficacy over single chemosensoryreceptor ligands, synergistic effects, etc.) in this establisheddiabetic rat model as detailed in the example below.

Diabetic rats and Wistar rats are selected for administration of theligands sucralose, Monosodium glutamate (MSG), fatty acid emulsion, andQuinine for the treatment of diabetes. Animals are grouped according todosage, and increasing dosages (sucralose range of 0.01-100 mg/kg; MSGrange of 0.01-100 mg/kg; fatty acid emulsion (e.g., Intralipid®) of 10%solution at 0.5-10 ml/min over ranges of 10 sec.-to 5 min; Quinine rangeof 0.01-100 mg/·kg) are utilized. Chemosensory receptor ligands areinstilled into the animals via silastic tubing inserted into theduodenum through the mouths of the lightly anesthetized animals.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test animals to prevent degradation of the targethormones by endogenous peptidases. DPP IV inhibition is accomplished viaco-administration of sitagliptin (10 mg/kg) at least one hour prior tochemosensory receptor ligand instillation.

Blood samples are collected via cannulation of the tail vein, andsamples are withdrawn at baseline, 15, 30, 60 and 120 minutespost-instillation. Blood samples are collected in collection tubescontaining standard cocktails of peptidase inhibitors and preservatives,and samples are stored at −25° C. until assayed. Blood samples areassayed for the presence of hormones related to insulin regulation,including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY, Insulin, Glucagon,C-peptide, Ghrelin, and GLP-2. Assays for the hormones are performedusing standard ELISA methodologies. Results are analyzed for efficacy ofchemosensory receptor ligand administration for the treatment ofdiabetic rats. Metabolites and other analyte concentrations, includingglucose, free fatty acids, triglycerides, calcium, potassium, sodium,magnesium, phosphate, are also assessed. Circulating concentrations ofat least one of the measured GLP-1, GLP-2, GIP, oxyntomodulin, PeptideYY, CCK, glucagon and insulinogenic index are expected to increase.

Example 11b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligands may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 11c

Alternatively, the experimental protocol above is performed withindustry standard Diet Induced Obese rats and applicable controls(healthy rats). Parameters unique to the obesity systems are modifiedbased on known standard assay conditions. Samples are collected andhormone assays performed as described above.

Example 12 Example 12a Lower GI Administration of Four ChemosensoryReceptor Ligands (Sweet, Umami, Fat, and Bitter) in Diabetic Rats

Numerous established and accepted diabetic rat models exist for theassessment of therapies for the treatment of diabetes. Four chemosensoryreceptor ligands (Sweet, MSG, fat, and bitter) can be assayed for thetreatment of diabetes (increased efficacy over single chemosensoryreceptor ligands, synergistic effects, etc.) in this establisheddiabetic rat model as detailed in the example below.

Diabetic rats are and Wistar rats selected for administration of thechemosensory receptor ligands sucralose, Monosodium glutamate (MSG),fatty acid emulsion, and Quinine for the treatment of diabetes. Animalsare grouped according to dosage, and increasing dosages (sucralose rangeof 0.01-100 mg/kg; MSG range of 0.01-100 mg/kg; fatty acid emulsion(e.g., Intralipid®) of 10% solution at 0.5-10 ml/min over ranges of 10sec.-to 5 min; Quinine range of 0.01-100 mg/kg) are utilized.Chemosensory receptor ligands are instilled into the animals viasilastic tubing inserted midway up the descending colon through therectum of the lightly anesthetized animals.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups or all of the test animals to prevent degradation of the targethormones by endogenous peptidases. DPP IV inhibition is accomplished viaco-administration of sitagliptin (10 mg/kg) at least one hour prior tochemosensory receptor ligand instillation.

Blood samples are collected via cannulation of the tail vein, andsamples are withdrawn at baseline, 15, 30, 60 and 120 minutespost-instillation. Blood samples are collected in collection tubescontaining standard cocktails of peptidase inhibitors and preservatives,and samples are stored at −25° C. until assayed. Blood samples areassayed for the presence of hormones related to insulin regulation,including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY, Insulin, Glucagon,C-peptide, Ghrelin, and GLP-2. Assays for the hormones are performedusing standard ELISA methodologies. Results are analyzed for efficacy ofchemosensory receptor ligand administration for the treatment ofdiabetic rats. Metabolites and other analyte concentrations, includingglucose, free fatty acids, triglycerides, calcium, potassium, sodium,magnesium, phosphate, are also assessed. Circulating concentrations ofat least one of the measured GLP-1, GLP-2, GIP, oxyntomodulin, PeptideYY, CCK, glucagon and insulinogenic index are expected to increase.

Example 12b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligands may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 12c

Alternatively, the experimental protocol above is performed withindustry standard Diet Induced Obese rats and applicable controls(healthy rats). Parameters unique to the obesity systems are modifiedbased on known standard assay conditions. Samples are collected andhormone assays performed as described above.

Example 13 Example 13a Upper GI Administration of Five ChemosensoryReceptor Ligands (Sweet, Umami, Fat, Bitter, and Bile Acid) in DiabeticRats

Numerous established and accepted diabetic rat models exist for theassessment of therapies for the treatment of diabetes. Five chemosensoryreceptor ligands (Sweet, MSG, fat, bitter, and Bile acid) can be assayedfor the treatment of diabetes (increased efficacy over singlechemosensory receptor ligands, synergistic effects, etc.) in thisestablished diabetic rat model as detailed in the example below.

Diabetic rats and Wistar rats are selected for administration of theligands sucralose, Monosodium glutamate (MSG), fatty acid emulsion,Quinine and Chenodeoxycholic acid (CDC) for the treatment of diabetes.Animals are grouped according to dosage, and increasing dosages(sucralose range of 0.01-100 mg/kg; MSG range of 0.01-100 mg/kg; fattyacid emulsion (e.g., Intralipid®) of 10% solution at 0.5-10 ml/min overranges of 10 sec.-5 min; Quinine range of 0.01-100 mg/·kg; CDC range at1-50 mMol solution at 1-10 ml/min over a range of 10 sec.-5 min.) areutilized. Chemosensory receptor ligands are instilled into the animalsvia silastic tubing inserted into the duodenum through the mouths of thelightly anesthetized animals.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test animals to prevent degradation of the targethormones by endogenous peptidases. DPP IV inhibition is accomplished viaco-administration of sitagliptin (10 mg/kg) at least one hour prior tochemosensory receptor ligand instillation.

Blood samples are collected via cannulation of the tail vein, andsamples are withdrawn at baseline, 15, 30, 60 and 120 minutespost-instillation. Blood samples are collected in collection tubescontaining standard cocktails of peptidase inhibitors and preservatives,and samples are stored at −25° C. until assayed. Blood samples areassayed for the presence of hormones related to insulin regulation,including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY, Insulin, Glucagon,C-peptide, Ghrelin, and GLP-2. Assays for the hormones are performedusing standard ELISA methodologies. Results are analyzed for efficacy ofchemosensory receptor ligand administration for the treatment ofdiabetic rats. Metabolites and other analyte concentrations, includingglucose, free fatty acids, triglycerides, calcium, potassium, sodium,magnesium, phosphate, are also assessed. Circulating concentrations ofat least one of the measured GLP-1, GLP-2, GIP, oxyntomodulin, PeptideYY, CCK, glucagon and insulinogenic index are expected to increase.

Example 13b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligands may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 13c

Alternatively, the experimental protocol above is performed withindustry standard Diet Induced Obese rats and applicable controls(healthy rats). Parameters unique to the obesity systems are modifiedbased on known standard assay conditions. Samples are collected andhormone assays performed as described above.

Example 14 Example 14a Lower GI Administration of Five ChemosensoryReceptor Ligands (Sweet, Umami, Fat, Bitter, and Bile Acid) in DiabeticRats

Numerous established and accepted diabetic rat models exist for theassessment of therapies for the treatment of diabetes. Five chemosensoryreceptor ligands (Sweet, MSG, fat, bitter, and Bile acid) can be assayedfor the treatment of diabetes (increased efficacy over singlechemosensory receptor ligands, synergistic effects, etc.) in thisestablished diabetic rat model as detailed in the example below.

Diabetic rats and Wistar rats are selected for administration of thechemosensory receptor ligands sucralose, Monosodium glutamate (MSG),fatty acid emulsion, Quinine and Chenodeoxycholic acid (CDC) for thetreatment of diabetes. Animals are grouped according to dosage, andincreasing dosages (sucralose range of 0.01-100 mg/kg; MSG range of0.01-100 mg/kg; fatty acid emulsion (e.g., Intralipid®) of 10% solutionat 0.5-10 ml/min over a range of 10 sec.-5 min; Quinine range of0.01-100 mg/kg; CDC range at 1-50 mMol solution at 1-10 ml/min over arange of 10 sec.-5 min.) are utilized. Chemosensory receptor ligands areinstilled into the animals via silastic tubing inserted midway up thedescending colon through the rectum of the lightly anesthetized animals.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups or all of the test animals to prevent degradation of the targethormones by endogenous peptidases. DPP IV inhibition is accomplished viaco-administration of sitagliptin (10 mg/kg) at least one hour prior tochemosensory receptor ligand instillation.

Blood samples are collected via cannulation of the tail vein, andsamples are withdrawn at baseline, 15, 30, 60 and 120 minutespost-instillation. Blood samples are collected in collection tubescontaining standard cocktails of peptidase inhibitors and preservatives,and samples are stored at −25° C. until assayed. Blood samples areassayed for the presence of hormones related to insulin regulation,including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY, Insulin, Glucagon,C-peptide, Ghrelin, and GLP-2. Assays for the hormones are performedusing standard ELISA methodologies. Results are analyzed for efficacy ofchemosensory receptor ligand administration for the treatment ofdiabetic rats. Metabolites and other analyte concentrations, includingglucose, free fatty acids, triglycerides, calcium, potassium, sodium,magnesium, phosphate, are also assessed. Circulating concentrations ofat least one of the measured GLP-1, GLP-2, GIP, oxyntomodulin, PeptideYY, CCK, glucagon and insulinogenic index are expected to increase.

Example 14b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligands may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 14c

Alternatively, the experimental protocol above is performed withindustry standard Diet Induced Obese rats and applicable controls(healthy rats). Parameters unique to the obesity systems are modifiedbased on known standard assay conditions. Samples are collected andhormone assays performed as described above.

Example 15 Example 15a Upper GI Administration of One ChemosensoryReceptor Ligand in Diabetic Human Subjects

Diabetic human subjects can be assessed for the efficacy of therapiesfor the treatment of diabetes. A single chemosensory receptor ligand(e.g., sweet) can be assayed for the treatment of diabetes as detailedin the example below.

Diabetic human subjects are selected for administration of thechemosensory receptor ligand (e.g., sucralose) for the treatment ofdiabetes. Non-diabetic human subjects are included for controls.Subjects are grouped according to dosage, and increasing dosages (e.g.,range of 0.01-100 mg/kg) are utilized. Chemosensory receptor ligands areinstilled into the subjects via specialized tubing (e.g., Ryle's tube)inserted into the duodenum/jejunal area. The tubes are introducednasogastrically and allowed to advance by peristalsis into the finallocation.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test subjects to prevent degradation of thetarget hormones by endogenous peptidases. DPP IV inhibition isaccomplished via co-administration of sitagliptin (100 mg/subject) atleast one hour prior to chemosensory receptor ligand instillation.

Blood samples are collected at baseline, at 15 minute intervals for thefirst hour post-instillation, and at 30 minute intervals for hours 2-4post-instillation. Blood samples are collected in collection tubescontaining standard cocktails of protease inhibitors (e.g., SigmaP8340—1/100 dilution and valine pyrrolidine—100 μM final concentration)and preservatives. Samples are stored at −25° C. until assayed. Bloodsamples are assayed for the presence of hormones related to insulinregulation, including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY,Insulin, Glucagon, C-peptide, Ghrelin, and GLP-2. Assays for thehormones are performed using standard ELISA methodologies. Results areanalyzed for efficacy of chemosensory receptor ligand administration forthe treatment of diabetic humans. Metabolites and other analyteconcentrations, including glucose, free fatty acids, triglycerides,calcium, potassium, sodium, magnesium, phosphate, are also assessed.Circulating concentrations of at least one of the measured GLP-1, GLP-2,GIP, oxyntomodulin, Peptide YY, CCK, glucagon and insulinogenic indexare expected to increase.

The experimental protocol is performed for five chemosensory receptorligand types (Sweet, Umami, Fat, Bitter, and Bile Acid) according theabove protocol. Exemplary ligands and respective dose ranges are asfollows:

Sucralose: 0.01-100 mg/kg

MSG: 0.01-100 mg/kg

Fatty acid emulsion: 10% solution at 0.5-10 ml/min over ranges of 10sec.-to 5 min.

Quinine: 0.01-100 mg/kg

Chenodeoxycholic acid (CDC): 1-50 mMol solution at 1-10 ml/min over arange of 10 sec.-5 min.

Example 15b

Alternatively, the chemosensory receptor ligand, if not metabolized, isadministered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligand may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 15c

Alternatively, the experimental protocol above is performed with obesehuman subjects or overweight human subjects and applicable controls(healthy human subjects). Parameters unique to the obesity systems aremodified based on known standard assay conditions. Samples are collectedand hormone assays performed as described above.

Example 16 Example 15a Lower GI Administration of One ChemosensoryReceptor Ligand in Diabetic Human Subjects

Diabetic human subjects can be assessed for the efficacy of therapiesfor the treatment of diabetes. A single chemosensory receptor ligand(e.g., sweet) can be assayed for the treatment of diabetes as detailedin the example below.

Diabetic and non-diabetic human subjects are selected for administrationof the chemosensory receptor ligand (e.g., sucralose) for the treatmentof diabetes. Subjects are grouped according to dosage, and increasingdosages (e.g., range of 0.01-100 mg/kg) are utilized. Chemosensoryreceptor ligands are instilled into the subjects via nasogastric tubinginserted midway up the descending colon through the rectum of the humansubjects.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test animals to prevent degradation of the targethormones by endogenous peptidases. DPP IV inhibition is accomplished viaco-administration of sitagliptin (100 mg/subject) at least one hourprior to chemosensory receptor ligand instillation.

Blood samples are collected at baseline, at 15 minute intervals for thefirst hour post-instillation, and at 30 minute intervals for hours 2-4post-instillation. Blood samples are collected in collection tubescontaining standard cocktails of protease inhibitors (e.g., SigmaP8340—1/100 dilution and valine pyrrolidine—100 μM final concentration)and preservatives. Samples are stored at −25° C. until assayed. Bloodsamples are assayed for the presence of hormones related to insulinregulation, including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY,Insulin, Glucagon, C-peptide, Ghrelin, and GLP-2. Assays for thehormones are performed using standard ELISA methodologies. Results areanalyzed for efficacy of chemosensory receptor ligand administration forthe treatment of diabetic humans. Metabolites and other analyteconcentrations, including glucose, free fatty acids, triglycerides,calcium, potassium, sodium, magnesium, phosphate, are also assessed.Circulating concentrations of at least one of the measured GLP-1, GLP-2,GIP, oxyntomodulin, Peptide YY, CCK, glucagon and insulinogenic indexare expected to increase.

The experimental protocol is performed for five chemosensory receptorligand types (Sweet, Umami, Fat, Bitter, and Bile Acid) according theabove protocol. Exemplary ligands and respective dose ranges are asfollows:

Sucralose: 0.01-100 mg/kg

MSG: 0.01-100 mg/kg

Fatty acid emulsion: 10% solution at 0.5-10 ml/min over ranges of 10sec.-to 5 min.

Quinine: 0.01-100 mg/kg

Chenodeoxycholic acid (CDC): 1-50 mMol solution at 1-10 ml/min over arange of 10 sec.-5 min.

Example 16b

Alternatively, the chemosensory receptor ligand, if not metabolized, isadministered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligand may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 16c

Alternatively, the experimental protocol above is performed with obesehuman subjects or overweight human subjects and applicable controls(healthy human subjects). Parameters unique to the obesity systems aremodified based on known standard assay conditions. Samples are collectedand hormone assays performed as described above.

Example 17 Example 17a Upper GI Administration of Two ChemosensoryReceptor Ligands in Diabetic Human Subjects

Diabetic human subjects can be assessed for the efficacy of therapiesfor the treatment of diabetes. Two chemosensory receptor ligands can beassayed for the treatment of diabetes as detailed in the example below.

Diabetic and nondiabetic human subjects are selected for administrationof the chemosensory receptor ligands for the treatment of diabetes.Subjects are grouped according to dosage, and increasing dosages areutilized. Chemosensory receptor ligands and cognate metabolites areinstilled into the subjects via specialized tubing (e.g., Ryle's tube)inserted into the duodenum/jejunal area. The tubes are introducednasogastrically and allowed to advance by peristalsis into the finallocation.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test subjects to prevent degradation of thetarget hormones by endogenous peptidases. DPP IV inhibition isaccomplished via co-administration of sitagliptin (100 mg/subject) atleast one hour prior to chemosensory receptor ligand instillation.

Blood samples are collected at baseline, at 15 minute intervals for thefirst hour post-instillation, and at 30 minute intervals for hours 2-4post-instillation. Blood samples are collected in collection tubescontaining standard cocktails of protease inhibitors (e.g., SigmaP8340—1/100 dilution and valine pyrrolidine—100 μM final concentration)and preservatives. Samples are stored at −25° C. until assayed. Bloodsamples are assayed for the presence of hormones related to insulinregulation, including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY,Insulin, Glucagon, C-peptide, Ghrelin, and GLP-2. Assays for thehormones are performed using standard ELISA methodologies. Results areanalyzed for efficacy of chemosensory receptor ligand administration forthe treatment of diabetic humans. Metabolites and other analyteconcentrations, including glucose, free fatty acids, triglycerides,calcium, potassium, sodium, magnesium, phosphate, are also assessed.Circulating concentrations of at least one of the measured GLP-1, GLP-2,GIP, oxyntomodulin, Peptide YY, CCK, glucagon and insulinogenic indexare expected to increase.

The experimental protocol is performed for combinations of twochemosensory receptor ligands including chemosensory receptor ligandtypes Sweet, Umami, Fat, Bitter, and Bile Acid according the aboveprotocol. Exemplary ligands and respective dose ranges are as follows:

Sucralose: 0.01-100 mg/kg

MSG: 0.01-100 mg/kg

Fatty acid emulsion: 10% solution at 0.5-10 ml/min over ranges of 10sec.-to 5 min.

Quinine: 0.01-100 mg/kg

Chenodeoxycholic acid (CDC): 1-50 mMol solution at 1-10 ml/min over arange of 10 sec.-5 min.

Example 17b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligand may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 17c

Alternatively, the experimental protocol above is performed with obesehuman subjects or overweight human subjects and applicable controls(healthy human subjects). Parameters unique to the obesity systems aremodified based on known standard assay conditions. Samples are collectedand hormone assays performed as described above.

Example 18 Example 18a Lower GI Administration of Two ChemosensoryReceptor Ligands in Diabetic Human Subjects

Diabetic human subjects can be assessed for the efficacy of therapiesfor the treatment of diabetes. Two chemosensory receptor ligands can beassayed for the treatment of diabetes as detailed in the example below.

Diabetic and nondiabetic human subjects are selected for administrationof the chemosensory receptor ligands for the treatment of diabetes.Subjects are grouped according to dosage, and increasing dosages (e.g.,range of 0.01-100 mg/kg) are utilized. Chemosensory receptor ligands areinstilled into the subjects via nasogastric tubing inserted midway upthe descending colon through the rectum of the human subjects.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test animals to prevent degradation of the targethormones by endogenous peptidases. DPP IV inhibition is accomplished viaco-administration of sitagliptin (100 mg/subject) at least one hourprior to chemosensory receptor ligand instillation.

Blood samples are collected at baseline, at 15 minute intervals for thefirst hour post-instillation, and at 30 minute intervals for hours 2-4post-instillation. Blood samples are collected in collection tubescontaining standard cocktails of protease inhibitors (e.g., SigmaP8340—1/100 dilution and valine pyrrolidine—100 μM final concentration)and preservatives. Samples are stored at −25° C. until assayed. Bloodsamples are assayed for the presence of hormones related to insulinregulation, including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY,Insulin, Glucagon, C-peptide, Ghrelin, and GLP-2. Assays for thehormones are performed using standard ELISA methodologies. Results areanalyzed for efficacy of chemosensory receptor ligand administration forthe treatment of diabetic humans. Metabolites and other analyteconcentrations, including glucose, free fatty acids, triglycerides,calcium, potassium, sodium, magnesium, phosphate, are also assessed.Circulating concentrations of at least one of the measured GLP-1, GLP-2,GIP, oxyntomodulin, Peptide YY, CCK, glucagon and insulinogenic indexare expected to increase.

The experimental protocol is performed for combinations of twochemosensory receptor ligands including chemosensory receptor ligandtypes Sweet, Umami, Fat, Bitter, and Bile Acid according the aboveprotocol. Exemplary ligands and respective dose ranges are as follows:

Sucralose: 0.01-100 mg/kg

MSG: 0.01-100 mg/kg

Fatty acid emulsion: 10% solution at 0.5-10 ml/min over ranges of 10sec.-to 5 min.

Quinine: 0.01-100 mg/kg

Chenodeoxycholic acid (CDC): 1-50 mMol solution at 1-10 ml/min over arange of 10 sec.-5 min.

Example 18b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligand may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 18c

Alternatively, the experimental protocol above is performed with obesehuman subjects or overweight human subjects and applicable controls(healthy human subjects). Parameters unique to the obesity systems aremodified based on known standard assay conditions. Samples are collectedand hormone assays performed as described above.

Example 19 Example 19b Upper GI Administration of Three ChemosensoryReceptor Ligands (Sweet, Umami, and Fat) in Diabetic Human Subjects

Diabetic human subjects can be assessed for the efficacy of therapiesfor the treatment of diabetes. Three chemosensory receptor ligands(Sweet, umami, and fat) can be assayed for the treatment of diabetes asdetailed in the example below.

Diabetic and nondiabetic human subjects are selected for administrationof the chemosensory receptor ligands sucralose, MSG and fatty acidemulsion for the treatment of diabetes. Subjects are grouped accordingto dosage, and increasing dosages (sucralose range of 0.01-100 mg/kg;MSG range of 0.01-100 mg/.kg; fatty acid emulsion (e.g., Intralipid®) of10% solution at 0.5-10 ml/min over ranges of 10 sec.-to 5 min.) areutilized. Chemosensory receptor ligands are instilled into the subjectsvia specialized tubing (e.g., Ryle's tube) inserted into theduodenum/jejunal area. The tubes are introduced nasogastrically andallowed to advance by peristalsis into the final location.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test subjects to prevent degradation of thetarget hormones by endogenous peptidases. DPP IV inhibition isaccomplished via co-administration of sitagliptin (100 mg/subject) atleast one hour prior to chemosensory receptor ligand instillation.

Blood samples are collected at baseline, at 15 minute intervals for thefirst hour post-instillation, and at 30 minute intervals for hours 2-4post-instillation. Blood samples are collected in collection tubescontaining standard cocktails of protease inhibitors (e.g., SigmaP8340—1/100 dilution and valine pyrrolidine—100 μM final concentration)and preservatives, and samples are stored at −25° C. until assayed.Blood samples are assayed for the presence of hormones related toinsulin regulation, including CCK, GIP, GLP-1, Oxyntomodulin, PeptideYY, Insulin, Glucagon, C-peptide, Ghrelin, and GLP-2. Assays for thehormones are performed using standard ELISA methodologies. Results areanalyzed for efficacy of chemosensory receptor ligand administration forthe treatment of diabetic humans. Metabolites and other analyteconcentrations, including glucose, free fatty acids, triglycerides,calcium, potassium, sodium, magnesium, phosphate, are also assessed.Circulating concentrations of at least one of the measured GLP-1, GLP-2,GIP, oxyntomodulin, Peptide YY, CCK, glucagon and insulinogenic indexare expected to increase.

Example 19b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligand may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 19c

Alternatively, the experimental protocol above is performed with obesehuman subjects or overweight human subjects and applicable controls(healthy human subjects). Parameters unique to the obesity systems aremodified based on known standard assay conditions. Samples are collectedand hormone assays performed as described above.

Example 20 Example 20a Lower GI Administration of Three ChemosensoryReceptor Ligands (Sweet, Umami, and Fat) in Diabetic Human Subjects

Diabetic human subjects can be assessed for the efficacy of therapiesfor the treatment of diabetes. Three chemosensory receptor ligands(Sweet, umami, and fat) can be assayed for the treatment of diabetes asdetailed in the example below.

Diabetic and nondiabetic human subjects are selected for administrationof the chemosensory receptor ligands sucralose, MSG, and fatty acidemulsion for the treatment of diabetes. Subjects are grouped accordingto dosage, and increasing dosages (sucralose range of 0.01-100 mg/kg;MSG range of 0.01-100 mg/.kg; fatty acid emulsion (e.g., Intralipid®) of10% solution at 0.5-10 ml/min over ranges of 10 sec.-to 5 min.) areutilized. Chemosensory receptor ligands are instilled into the subjectsvia nasogastric tubing inserted midway up the descending colon throughthe rectum of the human subjects.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test animals to prevent degradation of the targethormones by endogenous peptidases. DPP IV inhibition is accomplished viaco-administration of sitagliptin (100 mg/subject) at least one hourprior to chemosensory receptor ligand instillation.

Blood samples are collected at baseline, at 15 minute intervals for thefirst hour post-instillation, and at 30 minute intervals for hours 2-4post-instillation. Blood samples are collected in collection tubescontaining standard cocktails of protease inhibitors (e.g., SigmaP8340—1/100 dilution and valine pyrrolidine—100 μM final concentration)and preservatives. Samples are stored at −25° C. until assayed. Bloodsamples are assayed for the presence of hormones related to insulinregulation, including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY,Insulin, Glucagon, C-peptide, Ghrelin, and GLP-2. Assays for thehormones are performed using standard ELISA methodologies. Results areanalyzed for efficacy of chemosensory receptor ligand administration forthe treatment of diabetic humans. Metabolites and other analyteconcentrations, including glucose, free fatty acids, triglycerides,calcium, potassium, sodium, magnesium, phosphate, are also assessed.Circulating concentrations of at least one of the measured GLP-1, GLP-2,GIP, oxyntomodulin, Peptide YY, CCK, glucagon and insulinogenic indexare expected to increase.

Example 20b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligand may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 20c

Alternatively, the experimental protocol above is performed with obesehuman subjects or overweight human subjects and applicable controls(healthy human subjects). Parameters unique to the obesity systems aremodified based on known standard assay conditions. Samples are collectedand hormone assays performed as described above.

Example 21 Example 21a Upper GI Administration of Three ChemosensoryReceptor Ligands (Sweet, Umami, and Bitter) in Diabetic Human Subjects

Diabetic human subjects can be assessed for the efficacy of therapiesfor the treatment of diabetes. Three chemosensory receptor ligands(Sweet, umami, and bitter) can be assayed for the treatment of diabetesas detailed in the example below.

Diabetic and nondiabetic human subjects are selected for administrationof the chemosensory receptor ligands sucralose, MSG, and Quinine for thetreatment of diabetes. Subjects are grouped according to dosage, andincreasing dosages (sucralose range of 0.01-100 mg/kg; MSG range of0.01-100 mg/.kg; Quinine range of 0.01-100 mg/kg) are utilized.Chemosensory receptor ligands are instilled into the subjects viaspecialized tubing (e.g., Ryle's tube) inserted into theduodenum/jejunal area. The tubes are introduced nasogastrically andallowed to advance by peristalsis into the final location.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test subjects to prevent degradation of thetarget hormones by endogenous peptidases. DPP IV inhibition isaccomplished via co-administration of sitagliptin (100 mg/subject) atleast one hour prior to chemosensory receptor ligand instillation.

Blood samples are collected at baseline, at 15 minute intervals for thefirst hour post-instillation, and at 30 minute intervals for hours 2-4post-instillation. Blood samples are collected in collection tubescontaining standard cocktails of protease inhibitors (e.g., SigmaP8340—1/100 dilution and valine pyrrolidine—100 μM final concentration)and preservatives, and samples are stored at −25° C. until assayed.Blood samples are assayed for the presence of hormones related toinsulin regulation, including CCK, GIP, GLP-1, Oxyntomodulin, PeptideYY, Insulin, Glucagon, C-peptide, Ghrelin, and GLP-2. Assays for thehormones are performed using standard ELISA methodologies. Results areanalyzed for efficacy of chemosensory receptor ligand administration forthe treatment of diabetic humans. Metabolites and other analyteconcentrations, including glucose, free fatty acids, triglycerides,calcium, potassium, sodium, magnesium, phosphate, are also assessed.Circulating concentrations of at least one of the measured GLP-1, GLP-2,GIP, oxyntomodulin, Peptide YY, CCK, glucagon and insulinogenic indexare expected to increase.

Example 21b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligand may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 21c

Alternatively, the experimental protocol above is performed with obesehuman subjects or overweight human subjects and applicable controls(healthy human subjects). Parameters unique to the obesity systems aremodified based on known standard assay conditions. Samples are collectedand hormone assays performed as described above.

Example 22 Example 22a Lower GI Administration of Three ChemosensoryReceptor Ligands (Sweet, Umami, and Bitter) in Diabetic Human Subjects

Diabetic human subjects can be assessed for the efficacy of therapiesfor the treatment of diabetes. Three chemosensory receptor ligands(Sweet, umami, and bitter) can be assayed for the treatment of diabetesas detailed in the example below.

Diabetic and nondiabetic human subjects are selected for administrationof the chemosensory receptor ligands sucralose, MSG, and Quinine for thetreatment of diabetes. Subjects are grouped according to dosage, andincreasing dosages (sucralose range of 0.01-100 mg/kg; MSG range of0.01-100 mg/.kg; Quinine range of 0.01-100 mg/kg) are utilized.Chemosensory receptor ligands are instilled into the subjects vianasogastric tubing inserted midway up the descending colon through therectum of the human subjects.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test subjects to prevent degradation of thetarget hormones by endogenous peptidases. DPP IV inhibition isaccomplished via co-administration of sitagliptin (100 mg/subject) atleast one hour prior to chemosensory receptor ligand instillation.

Blood samples are collected at baseline, at 15 minute intervals for thefirst hour post-instillation, and at 30 minute intervals for hours 2-4post-instillation. Blood samples are collected in collection tubescontaining standard cocktails of protease inhibitors (e.g., SigmaP8340—1/100 dilution and valine pyrrolidine—100 μM final concentration)and preservatives, and samples are stored at −25° C. until assayed.Blood samples are assayed for the presence of hormones related toinsulin regulation, including CCK, GIP, GLP-1, Oxyntomodulin, PeptideYY, Insulin, Glucagon, C-peptide, Ghrelin, and GLP-2. Assays for thehormones are performed using standard ELISA methodologies. Results areanalyzed for efficacy of chemosensory receptor ligand administration forthe treatment of diabetic humans. Metabolites and other analyteconcentrations, including glucose, free fatty acids, triglycerides,calcium, potassium, sodium, magnesium, phosphate, are also assessed.Circulating concentrations of at least one of the measured GLP-1, GLP-2,GIP, oxyntomodulin, Peptide YY, CCK, glucagon and insulinogenic indexare expected to increase.

Example 22b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligand may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 22c

Alternatively, the experimental protocol above is performed with obesehuman subjects or overweight human subjects and applicable controls(healthy human subjects). Parameters unique to the obesity systems aremodified based on known standard assay conditions. Samples are collectedand hormone assays performed as described above.

Example 23 Example 23a Upper GI Administration of Three ChemosensoryReceptor Ligands (Sweet, Fat, and Bitter) in Diabetic Human Subjects

Diabetic human subjects can be assessed for the efficacy of therapiesfor the treatment of diabetes. Three chemosensory receptor ligands(Sweet, fat, and bitter) can be assayed for the treatment of diabetes asdetailed in the example below.

Diabetic and nondiabetic human subjects are selected for administrationof the chemosensory receptor ligands sucralose, fatty acid emulsion, andQuinine for the treatment of diabetes. Subjects are grouped according todosage, and increasing dosages (sucralose range of 0.01-100 mg/kg; fattyacid emulsion (e.g., Intralipid®) of 10% solution at 0.5-10 ml/min overranges of 10 sec.-to 5 min.; Quinine range of 0.01-100 mg/kg) areutilized. Chemosensory receptor ligands are instilled into the subjectsvia specialized tubing (e.g., Ryle's tube) inserted into theduodenum/jejunal area. The tubes are introduced nasogastrically andallowed to advance by peristalsis into the final location.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test subjects to prevent degradation of thetarget hormones by endogenous peptidases. DPP IV inhibition isaccomplished via co-administration of sitagliptin (100 mg/subject) atleast one hour prior to chemosensory receptor ligand instillation.

Blood samples are collected at baseline, at 15 minute intervals for thefirst hour post-instillation, and at 30 minute intervals for hours 2-4post-instillation. Blood samples are collected in collection tubescontaining standard cocktails of protease inhibitors (e.g., SigmaP8340—1/100 dilution and valine pyrrolidine—100 μM final concentration)and preservatives, and samples are stored at −25° C. until assayed.Blood samples are assayed for the presence of hormones related toinsulin regulation, including CCK, GIP, GLP-1, Oxyntomodulin, PeptideYY, Insulin, Glucagon, C-peptide, Ghrelin, and GLP-2. Assays for thehormones are performed using standard ELISA methodologies. Results areanalyzed for efficacy of chemosensory receptor ligand administration forthe treatment of diabetic humans. Metabolites and other analyteconcentrations, including glucose, free fatty acids, triglycerides,calcium, potassium, sodium, magnesium, phosphate, are also assessed.Circulating concentrations of at least one of the measured GLP-1, GLP-2,GIP, oxyntomodulin, Peptide YY, CCK, glucagon and insulinogenic indexare expected to increase.

Example 23b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligand may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 23c

Alternatively, the experimental protocol above is performed with obesehuman subjects or overweight human subjects and applicable controls(healthy human subjects). Parameters unique to the obesity systems aremodified based on known standard assay conditions. Samples are collectedand hormone assays performed as described above.

Example 24 Example 24a Lower GI Administration of Three ChemosensoryReceptor Ligands (Sweet, Fat, and Bitter) in Diabetic Human Subjects

Diabetic human subjects can be assessed for the efficacy of therapiesfor the treatment of diabetes. Three chemosensory receptor ligands(Sweet, fat, and bitter) can be assayed for the treatment of diabetes asdetailed in the example below.

Diabetic and nondiabetic human subjects are selected for administrationof the chemosensory receptor ligands sucralose, fatty acid emulsion, andquinine for the treatment of diabetes. Subjects are grouped according todosage, and increasing dosages (sucralose range of 0.01-100 mg/kg; fattyacid emulsion (e.g., Intralipid®) of 10% solution at 0.5-10 ml/min overranges of 10 sec.-to 5 min.; Quinine range of 0.01-100 mg/kg) areutilized. Chemosensory receptor ligands are instilled into the subjectsvia nasogastric tubing inserted midway up the descending colon throughthe rectum of the human subjects.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test subjects to prevent degradation of thetarget hormones by endogenous peptidases. DPP IV inhibition isaccomplished via co-administration of sitagliptin (100 mg/subject) atleast one hour prior to chemosensory receptor ligand instillation.

Blood samples are collected at baseline, at 15 minute intervals for thefirst hour post-instillation, and at 30 minute intervals for hours 2-4post-instillation. Blood samples are collected in collection tubescontaining standard cocktails of protease inhibitors (e.g., SigmaP8340—1/100 dilution and valine pyrrolidine—100 μM final concentration)and preservatives, and samples are stored at −25° C. until assayed.Blood samples are assayed for the presence of hormones related toinsulin regulation, including CCK, GIP, GLP-1, Oxyntomodulin, PeptideYY, Insulin, Glucagon, C-peptide, Ghrelin, and GLP-2. Assays for thehormones are performed using standard ELISA methodologies. Results areanalyzed for efficacy of chemosensory receptor ligand administration forthe treatment of diabetic humans. Metabolites and other analyteconcentrations, including glucose, free fatty acids, triglycerides,calcium, potassium, sodium, magnesium, phosphate, are also assessed.Circulating concentrations of at least one of the measured GLP-1, GLP-2,GIP, oxyntomodulin, Peptide YY, CCK, glucagon and insulinogenic indexare expected to increase.

Example 24b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligand may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 24c

Alternatively, the experimental protocol above is performed with obesehuman subjects or overweight human subjects and applicable controls(healthy human subjects). Parameters unique to the obesity systems aremodified based on known standard assay conditions. Samples are collectedand hormone assays performed as described above.

Example 25 Example 25a Upper GI Administration of Four ChemosensoryReceptor Ligands (Sweet, MSG, Fat, and Bitter) in Diabetic HumanSubjects

Diabetic human subjects can be assessed for the efficacy of therapiesfor the treatment of diabetes. Four chemosensory receptor ligands(Sweet, MSG, fat, and bitter) can be assayed for the treatment ofdiabetes as detailed in the example below.

Diabetic and nondiabetic human subjects are selected for administrationof the chemosensory receptor ligand sucralose, MSG, fatty acid emulsion,and Quinine for the treatment of diabetes. Subjects are groupedaccording to dosage, and increasing dosages (sucralose range of 0.01-100mg/kg; MSG range of 0.01-100 mg/kg; fatty acid emulsion (e.g.,Intralipid®) of 10% solution at 0.5-10 ml/min over ranges of 10 sec.-to5 min.; Quinine range of 0.01-100 mg/kg) are utilized. Chemosensoryreceptor ligands are instilled into the subjects via specialized tubing(e.g., Ryle's tube) inserted into the duodenum/jejunal area. The tubesare introduced nasogastrically and allowed to advance by peristalsisinto the final location.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test subjects to prevent degradation of thetarget hormones by endogenous peptidases. DPP IV inhibition isaccomplished via co-administration of sitagliptin (100 mg/subject) atleast one hour prior to chemosensory receptor ligand instillation.

Blood samples are collected at baseline, at 15 minute intervals for thefirst hour post-instillation, and at 30 minute intervals for hours 2-4post-instillation. Blood samples are collected in collection tubescontaining standard cocktails of protease inhibitors (e.g., SigmaP8340—1/100 dilution and valine pyrrolidine—100 μM final concentration)and preservatives, and samples are stored at −25° C. until assayed.Blood samples are assayed for the presence of hormones related toinsulin regulation, including CCK, GIP, GLP-1, Oxyntomodulin, PeptideYY, Insulin, Glucagon, C-peptide, Ghrelin, and GLP-2. Assays for thehormones are performed using standard ELISA methodologies. Results areanalyzed for efficacy of chemosensory receptor ligand administration forthe treatment of diabetic humans. Metabolites and other analyteconcentrations, including glucose, free fatty acids, triglycerides,calcium, potassium, sodium, magnesium, phosphate, are also assessed.Circulating concentrations of at least one of the measured GLP-1, GLP-2,GIP, oxyntomodulin, Peptide YY, CCK, glucagon and insulinogenic indexare expected to increase.

Example 25b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligand may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 25c

Alternatively, the experimental protocol above is performed with obesehuman subjects or overweight human subjects and applicable controls(healthy human subjects). Parameters unique to the obesity systems aremodified based on known standard assay conditions. Samples are collectedand hormone assays performed as described above.

Example 26 Example 26a Lower GI Administration of Four ChemosensoryReceptor Ligands (Sweet, MSG, Fat, and Bitter) in Diabetic HumanSubjects

Diabetic human subjects can be assessed for the efficacy of therapiesfor the treatment of diabetes. Four chemosensory receptor ligands(Sweet, MSG, fat, and bitter) can be assayed for the treatment ofdiabetes as detailed in the example below.

Diabetic and nondiabetic human subjects are selected for administrationof the chemosensory receptor ligand sucralose, MSG, fatty acid emulsion,and Quinine for the treatment of diabetes. Subjects are groupedaccording to dosage, and increasing dosages (sucralose range of 0.01-100mg/kg; MSG range of 0.01-100 mg/kg; fatty acid emulsion (e.g.,Intralipid®) of 10% solution at 0.5-10 ml/min over ranges of 10 sec.-to5 min.; Quinine range of 0.01-100 mg/kg) are utilized. Chemosensoryreceptor ligands are instilled into the subjects via nasogastric tubinginserted midway up the descending colon through the rectum of the humansubjects.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test subjects to prevent degradation of thetarget hormones by endogenous peptidases. DPP IV inhibition isaccomplished via co-administration of sitagliptin (100 mg/subject) atleast one hour prior to chemosensory receptor ligand instillation.

Blood samples are collected at baseline, at 15 minute intervals for thefirst hour post-instillation, and at 30 minute intervals for hours 2-4post-instillation. Blood samples are collected in collection tubescontaining standard cocktails of protease inhibitors (e.g., SigmaP8340—1/100 dilution and valine pyrrolidine—100 μM final concentration)and preservatives, and samples are stored at −25° C. until assayed.Blood samples are assayed for the presence of hormones related toinsulin regulation, including CCK, GIP, GLP-1, Oxyntomodulin, PeptideYY, Insulin, Glucagon, C-peptide, Ghrelin, and GLP-2. Assays for thehormones are performed using standard ELISA methodologies. Results areanalyzed for efficacy of chemosensory receptor ligand administration forthe treatment of diabetic humans. Metabolites and other analyteconcentrations, including glucose, free fatty acids, triglycerides,calcium, potassium, sodium, magnesium, phosphate, are also assessed.Circulating concentrations of at least one of the measured GLP-1, GLP-2,GIP, oxyntomodulin, Peptide YY, CCK, glucagon and insulinogenic indexare expected to increase.

Example 26b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligand may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 26c

Alternatively, the experimental protocol above is performed with obesehuman subjects or overweight human subjects and applicable controls(healthy human subjects). Parameters unique to the obesity systems aremodified based on known standard assay conditions. Samples are collectedand hormone assays performed as described above.

Example 27 Example 27a Upper GI Administration of Five ChemosensoryReceptor Ligands (Sweet, MSG, Fat, Bitter, and Bile Acid) in DiabeticHuman Subjects

Diabetic human subjects can be assessed for the efficacy of therapiesfor the treatment of diabetes. Five chemosensory receptor ligands(Sweet, MSG, fat, bitter, and bile acid) can be assayed for thetreatment of diabetes as detailed in the example below.

Diabetic and nondiabetic human subjects are selected for administrationof the chemosensory receptor ligands sucralose, MSG, Quinine, fatty acidemulsion, and Chenodeoxycholic acid (CDC) for the treatment of diabetes.Subjects are grouped according to dosage, and increasing dosages(sucralose range of 0.01-100 mg/kg; MSG range of 0.01-100 mg/kg; fattyacid emulsion (e.g., Intralipid®) of 10% solution at 0.5-10 ml/min overranges of 10 sec.-to 5 min.; Quinine range of 0.01-100 mg/kg; CDC rangeat 1-50 mMol solution at 1-10 ml/min over a range of 10 sec.-5 min.) areutilized. Chemosensory receptor ligands are instilled into the subjectsvia specialized tubing (e.g., Ryle's tube) inserted into theduodenum/jejunal area. The tubes are introduced nasogastrically andallowed to advance by peristalsis into the final location.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test subjects to prevent degradation of thetarget hormones by endogenous peptidases. DPP IV inhibition isaccomplished via co-administration of sitagliptin (100 mg/subject) atleast one hour prior to chemosensory receptor ligand instillation.

Blood samples are collected at baseline, at 15 minute intervals for thefirst hour post-instillation, and at 30 minute intervals for hours 2-4post-instillation. Blood samples are collected in collection tubescontaining standard cocktails of protease inhibitors (e.g., SigmaP8340—1/100 dilution and valine pyrrolidine—100 μM final concentration)and preservatives, and samples are stored at −25° C. until assayed.Blood samples are assayed for the presence of hormones related toinsulin regulation, including CCK, GIP, GLP-1, Oxyntomodulin, PeptideYY, Insulin, Glucagon, C-peptide, Ghrelin, and GLP-2. Assays for thehormones are performed using standard ELISA methodologies. Results areanalyzed for efficacy of chemosensory receptor ligand administration forthe treatment of diabetic humans. Metabolites and other analyteconcentrations, including glucose, free fatty acids, triglycerides,calcium, potassium, sodium, magnesium, phosphate, are also assessed.Circulating concentrations of at least one of the measured GLP-1, GLP-2,GIP, oxyntomodulin, Peptide YY, CCK, glucagon and insulinogenic indexare expected to increase.

Example 27b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligand may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 27c

Alternatively, the experimental protocol above is performed with obesehuman subjects or overweight human subjects and applicable controls(healthy human subjects). Parameters unique to the obesity systems aremodified based on known standard assay conditions. Samples are collectedand hormone assays performed as described above.

Example 28 Example 28a Lower GI Administration of Five ChemosensoryReceptor Ligands (Sweet, MSG, Fat, Bitter, and Bile Acid) in DiabeticHuman Subjects

Diabetic human subjects can be assessed for the efficacy of therapiesfor the treatment of diabetes. Five chemosensory receptor ligands(Sweet, MSG, fat, bitter, and bile acid) can be assayed for thetreatment of diabetes as detailed in the example below.

Diabetic and nondiabetic human subjects are selected for administrationof the chemosensory receptor ligands sucralose, MSG, Quinine, fatty acidemulsion, and Chenodeoxycholic acid (CDC) for the treatment of diabetes.Subjects are grouped according to dosage, and increasing dosages(sucralose range of 0.01-100 mg/kg; MSG range of 0.01-100 mg/kg; fattyacid emulsion (e.g., Intralipid®) of 10% solution at 0.5-10 ml/min overranges of 10 sec.-to 5 min.; Quinine range of 0.01-100 mg/kg; CDC rangeat 1-50 mMol solution at 1-10 ml/min over a range of 10 sec.-5 min.) areutilized. Chemosensory receptor ligands are instilled into the subjectsvia nasogastric tubing inserted midway up the descending colon throughthe rectum of the human subjects.

Optionally, Dipeptidyl Peptidase IV (DPP IV) is inhibited in designatedgroups, or all, of the test subjects to prevent degradation of thetarget hormones by endogenous peptidases. DPP IV inhibition isaccomplished via co-administration of sitagliptin (100 mg/subject) atleast one hour prior to chemosensory receptor ligand instillation.

Blood samples are collected at baseline, at 15 minute intervals for thefirst hour post-instillation, and at 30 minute intervals for hours 2-4post-instillation. Blood samples are collected in collection tubescontaining standard cocktails of protease inhibitors (e.g., SigmaP8340—1/100 dilution and valine pyrrolidine—100 μM final concentration)and preservatives, and samples are stored at −25° C. until assayed.Blood samples are assayed for the presence of hormones related toinsulin regulation, including CCK, GIP, GLP-1, Oxyntomodulin, PeptideYY, Insulin, Glucagon, C-peptide, Ghrelin, and GLP-2. Assays for thehormones are performed using standard ELISA methodologies. Results areanalyzed for efficacy of chemosensory receptor ligand administration forthe treatment of diabetic humans. Metabolites and other analyteconcentrations, including glucose, free fatty acids, triglycerides,calcium, potassium, sodium, magnesium, phosphate, are also assessed.Circulating concentrations of at least one of the measured GLP-1, GLP-2,GIP, oxyntomodulin, Peptide YY, CCK, glucagon and insulinogenic indexare expected to increase.

Example 28b

Alternatively, the chemosensory receptor ligands, if not metabolized,are administered with a cognate metabolite in the experimental protocolabove. For example in an alternative protocol, sucralose is administeredalong with glucose. The ligand may be administered in increasing doseswith respect to a fixed dose of the cognate metabolite and vice versa.

Example 28c

Alternatively, the experimental protocol above is performed with obesehuman subjects or overweight human subjects and applicable controls(healthy human subjects). Parameters unique to the obesity systems aremodified based on known standard assay conditions. Samples are collectedand hormone assays performed as described above.

Example 29 Dose-Response Studies for Individual and Combinations ofChemosensory Receptor Ligands

Chemosensory receptor ligands corresponding to each of the chemosensoryreceptor (Sucralose, MSG, Quinine, fatty acid emulsion, andChenodeoxycholic acid) and optionally cognate metabolites areindividually administered in diabetic rat upper GI and lower GI systemsas well as diabetic human upper GI and lower GI systems (see previousexamples for administration protocols for the rat and human systems inboth the upper GI and lower GI) to determine the optimum doses for eachchemosensory receptor ligand as well as the optional cognate metabolite(e.g., glucose). Subjects are administered sitagliptin (DPP IVinhibitor) at 10 mg/kg or 100 mg/subject in rats and humans respectivelyat least 60 minutes prior to chemosensory receptor ligand and optionalcognate metabolite infusion.

Chemosensory receptor ligands and optional cognate metabolites areadministered individually at increasing amounts (mg/kg/min), where eachsubject is administered a set mg/kg/min dose and the dose is maintainedat this set level for a 30 minute period. Blood samples are collected atfrequent intervals (e.g., every 1, 2, or 5 minutes) throughout the 30minute period and assayed for hormone levels. Hormones assayed includeCCK, GIP, GLP-1, Oxyntomodulin, Peptide YY, Insulin, Glucagon,C-peptide, Ghrelin, and GLP-2. Assays for the hormones are performedusing standard ELISA methodologies. Results are analyzed for efficacy ofchemosensory receptor ligand and optional cognate metaboliteadministration for the treatment of diabetic rats and humans.Metabolites and other analyte concentrations, including glucose, freefatty acids, triglycerides, calcium, potassium, sodium, magnesium,phosphate, are also assessed. Circulating concentrations of at least oneof the measured GLP-1, GLP-2, GIP, oxyntomodulin, Peptide YY, CCK,glucagon and insulinogenic index are expected to increase and changeaccording to the dosages given.

50% of maximal response dose and 50% of the maximum tolerated dose aredetermined for each chemosensory receptor ligand. Optionally, 25% ofmaximal response dose is determined for a cognate metabolite.

Alternatively, the experimental protocol above is performed with DietInduced Obese rats, obese human subjects or overweight human subjects,and applicable controls (healthy rat or human subjects). Parametersunique to the obesity systems are modified based on known standard assayconditions. Samples are collected and hormone assays performed asdescribed in Examples 1-28, above.

Example 30

Experiments to determine the effect of optional cognate metaboliteco-administration with the chemosensory receptor ligands are performedusing the human and rat systems described in Example 29.

Subjects (rats and humans, in both upper GI and lower GI) areadministered sitagliptin (DPP IV inhibitor) at 10 mg/kg or 100mg/subject in rats and humans respectively at least 60 minutes prior tochemosensory receptor ligand and glucose co-infusion. The chemosensoryreceptor ligands are individually co-administered at the 50% of maximalresponse dose with glucose at the 25% of maximal response dose.

Blood samples are collected at frequent intervals (e.g., every 1, 2, or5 minutes) throughout the 30 minute period and assayed for hormonelevels via standard ELISA methodologies including CCK, GIP, GLP-1,Oxyntomodulin, Peptide YY, Insulin, Glucagon, C-peptide, Ghrelin andGLP-2. Assays for the hormones are performed using standard ELISAmethodologies. Results are analyzed for efficacy of chemosensoryreceptor ligand and cognate metabolite administration for the treatmentof diabetic rats and humans. Metabolites and other analyteconcentrations, including glucose, free fatty acids, triglycerides,calcium, potassium, sodium, magnesium, phosphate, are also assessed.Circulating concentrations of at least one of the measured GLP-1, GLP-2,GIP, oxyntomodulin, Peptide YY, CCK, glucagon and insulinogenic indexare expected to increase and change according to the dosages given.

The effect of co-administration of a cognate metabolite (glucose) witheach chemosensory receptor ligand, as well as 50% of maximal dose and50% of maximum tolerated dose is thus determined.

Alternatively, the experimental protocol above is performed with DietInduced Obese rats, obese human subjects or overweight human subjects,and applicable controls (healthy rat or human subjects). Parametersunique to the obesity systems are modified based on known standard assayconditions. Samples are collected and hormone assays performed asdescribed in Examples 1-28, above.

Example 31

Experiments to determine the effect of the administration ofcombinations of chemosensory receptor ligands are performed in rat andhuman systems as described in Examples 1-28.

Each chemosensory receptor ligand of the combinations found in Examples1-28 is administered at the 50% of maximal response dose (determined asdescribed in Examples 28 and 29). Duplicate experiments are performedwhere optional cognate metabolites (e.g., glucose) is co-administered atthe 25% of maximal response (determined as described in Examples 29 and30).

Rat Blood Sample Collection

Blood samples are collected via cannulation of the tail vein, andsamples are withdrawn at baseline, 15, 30, 60 and 120 minutespost-instillation. Blood samples are collected in collection tubescontaining standard cocktails of peptidase inhibitors and preservatives,and samples are stored at −25° C. until assayed. Blood samples areassayed for the presence of hormones related to insulin regulation,including CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY, Insulin, Glucagon,C-peptide, Ghrelin and GLP-2. Assays for the hormones are performedusing standard ELISA methodologies. Results are analyzed for efficacy ofchemosensory receptor ligand and cognate metabolite administration forthe treatment of diabetic rats. Metabolites and other analyteconcentrations, including glucose, free fatty acids, triglycerides,calcium, potassium, sodium, magnesium, phosphate, are also assessed.Circulating concentrations of at least one of the measured GLP-1, GLP-2,GIP, oxyntomodulin, Peptide YY, CCK, glucagon and insulinogenic indexare expected to increase and change according to the dosages given.

Human Blood Sample Collection

Blood samples are collected at baseline, at 15 minute intervals for thefirst hour post-instillation, and at 30 minute intervals for hours 2-4post-instillation. Blood samples are collected in collection tubescontaining standard cocktails of protease inhibitors (e.g., SigmaP8340—1/100 dilution and valine pyrrolidine—100 μM final concentration)and preservatives, and samples are stored at −25° C. until assayed.Blood samples are assayed for the presence of hormones related toinsulin regulation, including CCK, GIP, GLP-1, Oxyntomodulin, PeptideYY, Insulin, Glucagon, C-peptide, Ghrelin and GLP-2. Assays for thehormones are performed using standard ELISA methodologies. Results areanalyzed for efficacy of chemosensory receptor ligand and cognatemetabolite administration for the treatment of diabetic humans.Metabolites and other analyte concentrations, including glucose, freefatty acids, triglycerides, calcium, potassium, sodium, magnesium,phosphate, are also assessed. Circulating concentrations of at least oneof the measured GLP-1, GLP-2, GIP, oxyntomodulin, Peptide YY, CCK,glucagon and insulinogenic index are expected to increase and changeaccording to the dosages given.

Example 32

Exemplary composition weighted to sweet receptor ligands and itsadministration.

Composition A Chemosensory Per oral solid dosage Receptor Ligand form(mg) Dose (mg) B.i.d. Daily Total Rebaudioside A 200 800 1600 Stevioside100 400 800 Sucralose 100 400 800 Quinine 2 8 16 L-Glutamine 50 200 400Oleic Acid 50 200 400

A single oral solid dosage form (e.g., tablet, pill, capsule, and thelike) includes the listed chemosensory receptor ligand components. Asingle dose for administration is a set of 4 units of the oral soliddosage form (e.g., 4 tablets or 4 capsules). Each of the 4 unitscontains identical chemosensory receptor ligand components; however eachindividual unit is formulated for release 80% of the chemosensoryreceptor ligand components at a different pH: pH 5.5, pH 6.0, pH 6.5,and pH 7.0 respectively. 20% of the chemosensory receptor ligandcomponents are released immediately. B.i.d. dosing occurs at 30 minutesto 1 hour prior to breakfast or the first meal of the day and 30 minutesto 1 hour prior to lunch or the second meal of the day. Alternatively,other dosing occurs, depending on the time of day during which foodintake is desired to be reduced, for example, b.i.d. dosing 30 minutesto 1 hour prior to lunch or the second meal of the day and 30 minutes to1 hour prior to dinner or the third meal of the day, or t.i.d. dosing 30minutes-1 hour before each meal of the day.

Example 33

Exemplary composition weighted to sweet receptor ligands and itsadministration.

Composition B Chemosensory Per oral solid dosage Receptor Ligand form(mg) Dose (mg) B.i.d. Daily Total Rebaudioside A 200 800 1600 Stevioside100 400 800 Sucralose 100 400 800 Quinine 2 8 16 L-Glutamine 50 200 400

A single oral solid dosage form (e.g., tablet, pill, capsule, and thelike) includes the listed chemosensory receptor ligand components. Asingle dose for administration is a set of 4 units of the oral soliddosage form (e.g., 4 tablets or 4 capsules). Each of the 4 unitscontains identical chemosensory receptor ligand components; however eachindividual unit is formulated for release at a different pH: pH 5.5, pH6.0 or pH 6.5. One unit releases approximately 20% of its components inabout 15 to about 60 mins after encountering an intestinal pH ofapproximately 5.5, and releases the remaining 80% of its components inabout 2 hrs. Another unit releases approximately 20% of its componentsin about 15 to about 60 mins after encountering an intestinal pH ofapproximately 6.0, and releases the remaining 80% of its components inabout 4 hrs. A third unit releases approximately 20% of its componentsin about 15 to about 60 mins after encountering an intestinal pH ofapproximately 6.5, and releases the remaining 80% of its components inabout 4 hrs. A fourth unit releases approximately 20% of its componentsin about 15 to about 60 mins after encountering an intestinal pH ofapproximately 6.0, and releases the remaining 80% of its components inabout 7 hrs. B.i.d. dosing occurs at 30 minutes to 1 hour prior tobreakfast or the first meal of the day and 30 minutes to 1 hour prior tolunch or the second meal of the day.

Example 34 Formulation of Composition B

The chemosensory receptor ligands of Composition B (Rebaudioside A,stevioside, sucralose, quinine and L-glutamine) are formulated intobilayer tablet cores with the excipients as indicated in the followingtable (expressed in proportional units).

IR CR7 CR4 CR2 Stevioside 13.3 16.0 16.0 16.0 Sucralose 13.3 16.0 16.016.0 Quinine sulfate 0.29 0.4 0.4 0.4 dihydrate L-Glutamine 6.7 8.0 8.08.0 Reb A 26.7 32.0 32.0 32.0 Prosol HD90 28.71 9.6 12.0 15.6 Pruv 3.03.0 3.0 3.0 Croscarmelose 4.0 — — — Sodium Methocel K4M — 11.0 8.6 5.0Klucel EXF 4.0 4.0 4.0 4.0

The IR column of the above table refers to 20% of the mass of thebilayer tablet that releases its contents in about 15 to about 60minutes. CR2, CR4, and CR7 refer to the remaining 80% of the componentsthat release over approximately 2, 4 or 7 hrs. A bilayer tablet core hasan IR compound and one of the CR, CR4 or CR7 components. With theexception of stevioside (>90 purity), the purity of all ingredientsis >99.8% and the concentrations of all impurities for all ingredientsare significantly below the limits set under International Conference onHarmonisation (ICH) guidance.

The bilayer tablet cores are coated with the following coatingcompositions for release at the indicated pH in the following table(expressed in proportional units).

IR/CR IR/CR IR/CR IR/CR 2 hr 4 hr 4 hr 7 hr Composition pH 5.5 pH 6.0 pH6.5 pH 6.0 Eudragit L30 D55 833.4 750.06 625.05 750.06 Eudragit FS 30D 083.34 208.35 83.34 Talc 125.0 Triethylcitrate 25.0 Water 1016

Example 35

Assessing efficacy of Composition B as described in Example 33 and 34 inobese human subjects.

The objective of this study is to assess the efficacy of a compositionand administration as described in Example 33 on weight loss andgylcemic control in obese human subjects. The study design is aplacebo-controlled, randomized, double blinded trial at three testingcenters and a duration of 16 weeks.

Total patient population: N=300. Patients are selected based on a bodymass index of greater than or equal to 30. 20% of the patient populationcan be diabetic (D&E, or stable metformin).

The dietary instruction is given at randomization only and excludeshypocaloric diets. Patients are assessed monthly with weightmeasurements and blood sampling along with a patient questionnaire.Blood samples are assayed for the presence of metabolic hormonesincluding CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY, insulin, glucagon,C-peptide, ghrelin and GLP-2 as well as plasma glucose via A1C (glycatedhemoglobin) concentrations.

Example 36

Assessing the effects of Composition B as described in Example 33 and 34in healthy human subjects.

The objective of this study is to assess the effect of a composition andadministration as described in Example 33 on hormone excursionsfollowing two meals in healthy human subjects. The study design is a8-day placebo-controlled, cross-over trial. Healthy patients are dividedinto two groups that receive either placebo or the composition describedin Example 33 on Days 1-3 twice daily, 30 minutes to 1 hour prior tobreakfast and lunch. On Day 4, blood samples are collected prior toadministration of the composition and at 15 minute intervals post-mealfor 2 hours. Blood samples are collected in collection tubes containingstandard cocktails of protease inhibitors and preservatives, and samplesare stored at −25° C. until assayed. The process is repeated for Days5-8 with the placebo group receiving the composition and the compositiongroup now receiving the placebo.

Blood samples are assayed for the presence of metabolic hormonesincluding CCK, GIP, GLP-1, Oxyntomodulin, Peptide YY, insulin, glucagon,C-peptide, ghrelin and GLP-2 as well as plasma glucose via A1C (glycatedhemoglobin) concentrations. Positive patient outcome and response to thestudy is defined as an increase in GLP-1, GIP, Peptide YY, orOxyntomodulin plasma AUC with the composition as described in Example 33over placebo and/or a decrease in glucose AUC with the composition asdescribed in Example 33 over placebo. A 20% increase of the hormone, ora 20% decrease in glucose is defined as very significant.

Example 37

An 8-Day, Randomized, Cross-Over, Blinded, Placebo-Controlled, SingleCenter Study Assessing The Efficacy Of Composition B as Described inExample 33 and 34 On Meal-Driven Hormone Levels. In The Circulation OfObese Volunteers

An 8 day clinical study as designed to examine the effect of CompositionB on meal-driven, gut hormone profiles in overweight volunteers.

Indication

The effect of Composition B versus Placebo is compared on gut hormonerelease.

Rationale

Study: To examine Composition B's effect on gut hormone release andtherapeutic possibility in the treatment of obesity.

Sitagliptin (Januvia): Because gut hormones GLP-1 and PYY as well asothers are rapidly broken down by the peptidase DPP-IV, subjects wereasked to ingest 100 mg of the DPP-IV inhibitor sitagliptin (Januvia) anapproved medication for the treatment of diabetes on the morning of eachmeal test day (day 4 and 8).

Objectives

Primary: To assess the effects of Composition B on Glucagon-LikePeptide-1, Peptide YY and other gut hormone concentrations in thebloodstream before, and during, a standard breakfast and lunch afteradministration of Composition B or Placebo.

Secondary: To assess the effects of Composition B on plasma glucose,insulin, and triglycerides serum concentrations, before, and during, astandard breakfast and lunch after administration of Composition B orPlacebo.

Trial Design

The trial was a double-blind, randomized, single center study using across-over design. Male and female subjects with obesity were includedin this study. Approximately 10 eligible subjects who had given theirinformed consent to participate were randomized to one of the followingtreatments:

-   -   Composition B    -   Placebo

Subjects were randomized at visit 2 to equal groups of 5 on Placebo and5 on Composition B. They were asked to take their assigned therapeuticproduct (Composition B or Placebo) by mouth 30-60 minutes prior tobreakfast and lunch or the first and second meal of the day. Thetherapeutic product was composed of 4 tablets packaged together in asealed pouch. After 3 days of therapy, subjects returned to the clinicearly on the morning of the 4th day (visit 3) where they took thetherapeutic product and ingested 100 mg of sitagliptin (Januvia), andsubsequently received the test standard meals. During the meals, bloodwas drawn from an indwelling catheter for various hormone and analytemeasurements. After the meal tests were administered on the 4th day,subjects on Placebo and Composition B were crossed over to the othertherapy and asked to ingest the therapeutic product for days 5-7. On day8 (visit 4), subjects returned to the clinic early on the morning of the8th day where they took the therapeutic product and 100 mg ofsitagliptin, and subsequently received the test standard meals,similarly to day 4.

Inclusion Criteria

-   -   Male/female    -   All races    -   Impaired fasting glucose/Prediabetes (fasting blood glucose        100-125 mg/dl)    -   Diabetes (fasting blood glucose>126 mg/dl) if fasting blood        glucose is less or equal to 140 mg/dl on no current diabetes        treatment    -   Smokers allowed (but not smoking during the study period)    -   BMI 27-40 inclusive    -   Healthy with no health problems requiring medications    -   Willingness to take 4 pills twice per day    -   Willingness to adhere to protocol        Exclusion Criteria    -   Age<18 and >65 years    -   BMI less than 27    -   BMI over 40    -   Any current drug treatment (prescription or over-the-counter        medications, including any antacids such as Rolaids or Pepsid).        Subjects may take acute intermittent over-the-counter        medications (such as Tylenol), if needed.    -   Any nutritional supplement for weight loss    -   Any chronic disease requiring medication    -   Surgery of any kind 6 months prior    -   History of gastrointestinal surgery    -   History of weight-loss within 3 months of screening    -   History of major weight loss (>20% body weight)    -   Current infections    -   Inability to swallow 8 pills per day    -   History of diabetes requiring drug therapy    -   Blood pressure>160 mmHg systolic or 95 mmHg diastolic    -   Resting heart rate>90 BPM    -   Pregnancy or desire to become pregnant during the study    -   Excessive alcohol intake (more than 14 drinks/week)        Trial Treatments

Subjects were randomized in a 1:1 ratio to one of the followingtreatment arms: Composition B or Placebo.

At screening (Visit 1), inclusion/exclusion was assessed.

At randomization (Visit 2), subjects were assigned to one of twotreatment groups, Placebo or Composition B. The assigned treatment wastaken for 4 days. At Visit 3 subjects originally assigned to Placebo atVisit 2 was switched to Composition B, and subjects originally assignedto Composition B at Visit 2 was switched to Placebo and subjects tooktheir newly assigned treatment for an additional 4 days.

Activity Schedule

Screening Randomization/Day 1 Day 4 Day 8 (Visit 1) (Visit 2) Day 2 Day3 (Visit 3) Day 5 Day 6 Day 7 (Visit 4) Clinic Visit X X X X InformedConsent X Vital Signs X X X X Height/Weight X X X X Med/Surg Hx X X X Xor changes Con Meds X X X X Demographics X AEs X X Chemistry Panel XPregnancy Test X Glucose X X X Insulin X X X Triglycerides X X X GLP-1 XX X PYY X X X Amylin (active and total) X X X Ghrelin (active and total)X X X C-Peptide X X X Oxyntomodulin X X X GIP (total) X X X CCK X X XPlacebo/Composition B X X X X X X X X dosing Januvia dosing X X MealTest X XVolunteer Instructions

During the period of study, volunteers were instructed to go about theirusual daily lives. They were discouraged from engaging in strenuousexercise or changing their usual lifestyle. Volunteers were instructednot to smoke or drink coffee during the study period. They were toreport any side effects, or changes in how they feel. If they had theneed to take acute medication during the trial such as aspirin,acetaminophen, or allergy medications they were instructed to report itbut they were told that it would not disqualify them from the study.

Study Procedures

Screening (Visit 1) assessed subjects for inclusion/exclusion.

Randomization—Day 1 (Visit 2)

-   -   Randomization occurred about 4 weeks of Visit 1.    -   Volunteers showed up to clinic fasting prior to 8:00 AM.    -   Vital signs, height, weight, baseline bloods (fasting and        postprandial insulin, glucose, triglyceride, GLP-1 (active and        total), PYY (active and total), GIP, ghrelin (active and total),        amylin (active and total), C-Peptide, CCK and oxyntomodulin)        were taken.    -   Assigned treatment arm (randomization)    -   Composition B or Placebo tablets was provided for 4 days of        treatment (8 packets, each containing 4 tablets).    -   Volunteers took 4 tablets (one packet) approximately 30-60        minutes prior to breakfast and lunch or the first and second        meal of the day.    -   First dose (4 tablets) was taken on visit 1    -   Volunteers were allowed to have breakfast after their fasting        blood draws and after taking their first dose (4 tablets)    -   Volunteers were discharged from the clinic and instructed to        take their tablets each day 30-60 minutes prior to breakfast and        lunch on days 1, 2 and 3.    -   Volunteers were instructed to return to the clinic on day 4        fasting

Day 2

-   -   Volunteers took 4 tablets (one packet) approximately 30-60        minutes prior to breakfast and lunch or the first and second        meal of the day.

Day 3

-   -   Volunteers took 4 tablets (one packet) approximately 30-60        minutes prior to breakfast and lunch or the first and second        meal of the day.

Day 4 (Visit 3)—Meal Profiles

-   -   Volunteers showed up to clinic fasting prior to 8:00 AM.    -   Blood drawing access was established via an indwelling catheter.    -   Vital signs, height, weight were taken    -   At t=−90 minutes baseline1 bloods were drawn and processed as        appropriate for each analyte (fasting and postprandial insulin,        glucose, triglyceride, GLP-1 (active and total), PYY (active and        total), GIP, ghrelin (active and total), amylin (active and        total), C-Peptide, CCK and oxyntomodulin).    -   At t=−80 minutes one tablet of Januvia 100 mg (sitagliptin 100        mg) was administered by mouth with a 4 oz glass of water.    -   At t=−60 minutes one dose (4 tablets) of Composition B or        Placebo was administered by mouth with 4 oz of water.    -   At t=−5 minutes baseline bloods were drawn and processed as        appropriate for each analyte.    -   At t=0 breakfast was provided to be consumed over at most 20        minutes. Breakfast was 600 Kcal, composed with a caloric        distribution of 60% carbohydrate, 15% protein and 25% fat.    -   At t=30 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=60 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=90 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t-120 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=180 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=185 minutes, one dose (4 tablets) of Composition B or        Placebo was administered by mouth with 4 oz of water.    -   At t=235 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=240 minutes lunch was provided to be ingested over at most        20 minutes    -   Lunch was provided to be consumed over at most 20 minutes. Lunch        was 1000 Kcal, composed with a caloric distribution of 60%        carbohydrate, 15% protein and 25% fat.    -   At t=270 minutes Bloods were drawn and processed as appropriate        for each analyte.    -   At t=300 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=330 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=360 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=420 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=480 minutes bloods were drawn and processed as appropriate        for each analyte.    -   After the 480 minute blood draw the volunteer was eligible for        discharge.    -   Upon discharge the volunteer was provided with 4 days of drug (8        packets).    -   Volunteers were discharged from the clinic and instructed to        take their tablets each day 30-60 minutes prior to breakfast and        lunch on days 1, 2 and 3.    -   Volunteers were instructed to return to the clinic on day 8        fasting.

Day 5

-   -   Volunteers took 4 tablets (one packet) approximately 30-60        minutes prior to breakfast and lunch or the first and second        meal of the day.

Day 6

-   -   Volunteers took 4 tablets (one packet) approximately 30-60        minutes prior to breakfast and lunch or the first and second        meal of the day.

Day 7

-   -   Volunteers took 4 tablets (one packet) approximately 30-60        minutes prior to breakfast and lunch or the first and second        meal of the day.

Day 8 (Visit 4)—Meal Profiles

-   -   Volunteers showed up to clinic fasting prior to 8:00 AM.    -   Blood drawing access was established via an indwelling catheter.    -   Vital signs, height, weight are taken.    -   At t=−90 minutes baseline1 bloods were drawn and processed as        appropriate for each analyte.    -   At t=−80 minutes one tablet of Januvia 100 mg (sitagliptin 100        mg) was administered by mouth with a 4 oz glass of water    -   At t=−60 minutes one dose (4 tablets) of Composition B or        Placebo was administered by mouth with 4 oz of water    -   At t=−5 minutes baseline2 bloods were drawn and processed as        appropriate for each analyte.    -   At t=0 breakfast was provided to be consumed over at most 20        minutes. Breakfast was 600 Kcal, composed with a caloric        distribution of 60% carbohydrate, 15% protein and 25% fat.    -   At t=30 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=60 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=90 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=120 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=180 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=185 minutes, one dose (4 tablets) of Composition B or        Placebo was administered by mouth with 4 oz of water.    -   At t=235 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=240 lunch was provided to be consumed over at most 20        minutes. Lunch was 1000 Kcal, composed with a caloric        distribution of 60% carbohydrate, 15% protein and 25% fat.    -   At t=270 minutes Bloods were drawn and processed as appropriate        for each analyte.    -   At t=300 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=330 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=360 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=420 minutes bloods were drawn and processed as appropriate        for each analyte.    -   At t=480 minutes bloods were drawn and processed as appropriate        for each analyte.    -   After the 480 minutes blood draw the volunteer was eligible for        discharge.        Results

It was observed that the circulating hormone levels and/orconcentrations of at least GLP (total), GLP (active), insulin, PYY(total) and PYY 3-36 were increased with Composition B as compared tothe circulating hormone levels and/or concentrations with a placebocomposition.

Example 38 Satiety Study

Satiety and satiation studies are performed in the population ofinterest (e.g. healthy lean, overweight, obese, morbidly obese, patientswith type 2 diabetes) in a controlled setting appropriate for suchstudies. Studies are conducted in a randomized, double-blind, placebocontrolled fashion to evaluate the effect of compositions providedherein, including Composition B and/or B. Patients are asked to completea satiety questionnaire and visual analog scales (VAS) to determinetheir level of hunger prior to food intake and satiation after foodintake. Also they are probed regarding food preferences and cravings.Volunteers have access to a buffet and are free to access as much foodas desired. The food is weighed or otherwise quantitated so as todetermine the total caloric value of the food ingested. A satietyquotient is calculated (i.e. VAS for satiety divided by the amount ofcalories ingested. Subjects in active arms of the studies report anincrease the satiety index, i.e., produce greater satiety at a lowercaloric intake when compared to placebo.

While certain embodiments of the present invention have been shown anddescribed herein, it will be obvious to those skilled in the art thatsuch embodiments are provided by way of example only. Numerousvariations, changes, and substitutions will now occur to those skilledin the art without departing from the invention. It should be understoodthat various alternatives to the embodiments of the invention describedherein may be employed in practicing the invention. It is intended thatthe following claims define the scope of the invention and that methodsand structures within the scope of these claims and their equivalents becovered thereby.

What is claimed is:
 1. A method of increasing the circulatingconcentration of one or more of GLP-1 (total), GLP-1 (active), PYY(total), PYY 3-36, and insulin in a subject comprising administeringorally a composition comprising a non-nutritive sweet receptor agonist,wherein said composition is adapted to release said non-nutritive sweetreceptor agonist to one or more regions of the intestine of a subjectselected from the group consisting of the duodenum, jejunum, ileum,caecum, colon, rectum, and combinations thereof.
 2. A method accordingto claim 1, wherein said composition further releases at least some ofsaid non-nutritive sweet receptor agonist in the stomach.
 3. A methodaccording to claim 1, wherein said composition is adapted to releasesaid non-nutritive sweet receptor agonist distal to the duodenum.
 4. Amethod according to claim 1, wherein said one or more regions of theintestine are the jejunum, ileum, caecum, colon, rectum, or combinationsthereof.
 5. A method according to claim 1, wherein said compositionreleases said non-nutritive sweet receptor agonist at an onset of about5 to about 45 minutes, about 105 to about 135 minutes, about 165 toabout 195 minutes, about 225 to about 255 minutes, or a combination oftimes thereof following administration to said subject.
 6. A methodaccording to claim 1, wherein said composition releases saidnon-nutritive sweet receptor agonist at an onset of about pH 5.0, aboutpH 5.5, about pH 6.0, about pH 6.5, about pH 7.0, or combination thereoffollowing administration to said subject.
 7. A method according to claim1, wherein said composition further comprises a bitter receptor ligand,an umami receptor ligand, a fat receptor ligand, a bile acid receptorligand, or a combination thereof.
 8. A method according to claim 1,wherein said non-nutritive sweet receptor agonist is selected from thegroup consisting of sucralose, aspartame, Stevioside, Rebaudioside A,Rebaudioside B, Rebaudioside C, Rebaudioside D, Rebaudioside E,Rebaudioside F, Neotame, acesulfame-K, and saccharin.
 9. A methodaccording to claim 7, wherein said bitter receptor ligand is selectedfrom the group consisting of a flavanone, a flavone, a flavonol, aflavan, a phenolic flavonoid, an isoflavone, a limonoid aglycone, aglucosinolate or hydrolysis product thereof, and an organicisothiocyanate.
 10. A method according to claim 7, wherein said umamireceptor ligand is selected from the group consisting of glutamate salt,glutamine, acetyl glycine, and aspartame.
 11. A method according toclaim 7, wherein said fat receptor ligand is selected from the groupconsisting of a linoleic acid, an oleic acid, an omega-3 fatty acid, apalmitate, an oleoylethanolamide, a mixed fatty acid emulsion, and anN-acylphosphatidylethanolamine (NAPE).
 12. A method according to claim7, wherein said bile acid receptor ligand is selected from the groupconsisting of deoxycholic acid, a taurocholic acid, and achenodeoxycholic acid.
 13. A method according to claim 1, wherein saidcomposition is administered prior to ingestion of food by said subject.14. A method according to claim 1, wherein said subject is undergoingbariatric surgery.
 15. A method according to claim 1, further comprisingadministration of a drug for diabetes or obesity.
 16. A method accordingto claim 8, wherein said non-nutritive sweet receptor agonist isRebaudioside A.
 17. A method according to claim 1, wherein saidcomposition further comprises an unami receptor agonist and a bitterreceptor agonist.
 18. A method according to claim 1, wherein saidcomposition is enterically coated.